[THE CRITICAL INCIDENTS IN THE COMBINED ANESTHESIA DURING MAJOR ABDOMINAL SURGERY IN ELDERRY AND OLD PATIENTS: ROLE PREOPERATIVE LEVEL OF WAKEFULNESS.

Science.gov (United States)

Veyler, R V; Musaeva, T S; Trembach, N V; Zabolotskikh, I B

2016-09-01

to determine patterns during combined anesthesia andfrequency ofcritical incidents, depending on the initial level of wakefulness and patient age. 158 patients of planning operated under combined anesthesia for colon tumors were divided into two groups of elderly patients (n= 79) and old (n= 79). Each group was divided into 3 subgroups, depending on level of wakefulness, the estimatedfor level of direct current potential: low, optimum and high levels ofwakefulness. Relations of age and level ofwakefulness with afrequency of critical incidents. In the number of registered incidents included hemodynamic incidents: hypotension, hypertension, bradycardia, arrhythmia and tachycardia; respiratory incidents: hypoxemia, hypercapnia, the needfor prolonged postoperative mechanical ventilation; metabolic incidents: hypothermia, slow recovery of neuromuscular conduction, slow postoperative awakening has been studied. The most frequent incidents in our study were hemodynamic incidents, which prevailed in the structure of hypotension and hypertension. Among of the respiratory incidents dominated by hypoxia and hypercapnia. In the group of elderly patients the most incidents occurred in the subgroup with low level of wakefulness, while in the oldest patients statistically group significant differences between the groups were not found Conclusion. Frequency of critical incidents does not only depend from the age but also from a preoperative level of wakefulness; frequency was lower in elderly patients with an optimum level of wakefulness, and the low level of wakefulness - was high regardless of age.

Dependency in Critically Ill Patients

Directory of Open Access Journals (Sweden)

Rumei Yang

2016-03-01

Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.

Using the critical incident survey to assess hospital service quality.

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Longo, B; Connor, G; Barnhart, T

1993-01-01

This survey was designed to determine "standards of excellence" in hospital services as defined by (a) former patients, (b) physicians, (c) hospital employees, and (d) corporate insurance subscribers. One hundred forty-seven (147) patients, 188 employees, and 20 corporate subscribers were interviewed by telephone, and 52 physicians were interviewed in their offices. The interview consisted of a single question: "Can you think of a time when, as a patient/employee/employer/physician, you had a particularly satisfying or dissatisfying experience with a local hospital?" Reported incidents were reviewed, and 239 "critical incidents" were identified. These incidents were classified into 12 descriptive categories relating to the underlying factors in the incident reports. Six focus groups were later held with participants segregated by the population pool they represented. These groups were asked to develop definitions of "excellence" in hospital service quality and standards for service which would "exceed expectations." The focus groups created 122 standards of excellence, which were classified into 43 categories. Overall, the largest percentages of corporate, physician, and employee critical incidents were classified as "Administrative Policy" issues. Patients most often reported "Nurturing" incidents as critical to their perceptions of hospital service quality.

Examining critical care nurses' critical incident stress after in hospital cardiopulmonary resuscitation (CPR).

Science.gov (United States)

Laws, T

2001-05-01

The object of this study was to determine if critical care nurses' emotional responses to having performed cardiopulmonary resuscitation were indicative of critical incident stress. A descriptive approach was employed using a survey questionnaire of 31 critical care nurses, with supportive interview data from 18 of those participants. Analysis of the data generated from the questionnaire indicated that the respondents experienced thought intrusion and avoidance behaviour. A majority of those interviewed disclosed that they had experienced a wide range of emotional stressors and physical manifestations in response to having performed the procedure. The findings from both questionnaire and interview data were congruent with signs of critical incident stress, as described in the literature. This has been found to be detrimental to employees' mental health status and, for this reason, employers have a duty of care to minimise the risk of its occurrence and to manage problems as they arise.

Critical incidents related to cardiac arrests reported to the Danish Patient Safety Database

DEFF Research Database (Denmark)

Andersen, Peter Oluf; Maaløe, Rikke; Andersen, Henning Boje

2010-01-01

Background Critical incident reports can identify areas for improvement in resuscitation practice. The Danish Patient Safety Database is a mandatory reporting system and receives critical incident reports submitted by hospital personnel. The aim of this study is to identify, analyse and categorize...... critical incidents related to cardiac arrests reported to the Danish Patient Safety Database. Methods The search terms “cardiac arrest” and “resuscitation” were used to identify reports in the Danish Patient Safety Database. Identified critical incidents were then classified into categories. Results One...

Critical incidence reporting systems - an option in equine anaesthesia? Results from a panel meeting.

Science.gov (United States)

Hartnack, Sonja; Bettschart-Wolfensberger, Regula; Driessen, Bernd; Pang, Daniel; Wohlfender, Franziska

2013-11-01

To provide a brief introduction into Critical Incident Reporting Systems (CIRS) as used in human medicine, and to report the discussion from a recent panel meeting discussion with 23 equine anaesthetists in preparation for a new CEPEF-4 (Confidential Enquiry into Perioperative Equine Fatalities) study. Moderated group discussions, and review of literature. The first group discussion focused on the definition of 'preventable critical incidents' and/or 'near misses' in the context of equine anaesthesia. The second group discussion focused on categorizing critical incidents according to an established framework for analysing risk and safety in clinical medicine. While critical incidents do occur in equine anaesthesia, no critical incident reporting system including systematic collection and analysis of critical incidents is in place. Critical incident reporting systems could be used to improve safety in equine anaesthesia - in addition to other study types such as mortality studies. © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

Supporting staff recovery and reintegration after a critical incident resulting in infant death.

Science.gov (United States)

Roesler, Roberta; Ward, Debra; Short, Mary

2009-08-01

A critical incident is described as any sudden unexpected event that has the power to overwhelm the usual effective coping skills of an individual or a group and can cause significant psychological distress in usually healthy persons. A Just Culture model to deal with critical incidents is an approach that seeks to identify and balance system events and personal accountability. This article reports a critical incident that occurred at the Neonatal Intensive Care Unit, Methodist Hospital of Indianapolis, when 5 infants received an overdose of heparin that resulted in the death of 3 infants. Although care of the family after the critical incident was the immediate priority, the focus of this article was on the recovery and reintegration of the NICU staff after a critical incident based on the Just Culture philosophy.

Dealing Collectively with Critical Incident Stress Reactions in High Risk Work Environments

DEFF Research Database (Denmark)

Müller-Leonhardt, Alice; Strøbæk, Pernille Solveig; Vogt, joachim

2015-01-01

organisations. Indeed, we found that the CISM programme once integrated within the socio-cultural patterns of this specific working environment enhanced not only individual feelings of being supported but also organisational safety culture. Keywords: coping; safety culture; critical incident stress management......aim of this paper is to shift the representation of coping patterns within high risk occupations to an existential part of cultural pattern and social structure, which characterises high reliability organisations. Drawing upon the specific peer model of critical incident stress management (CISM......), in which qualified operational peers support colleagues who experienced critical incident stress, the paper discusses critical incident stress management in air traffic control. Our study revealed coping patterns that co-vary with the culture that the CISM programme fostered within this specific high...

Analysing Users' Satisfaction with E-Learning Using a Negative Critical Incidents Approach

Science.gov (United States)

Chen, Nian-Shing; Lin, Kan-Min; Kinshuk

2008-01-01

One critical success factor for e-learning is learners' satisfaction with it. This is affected by both positive and negative experiences in a learning process. This paper examines the impact of such critical incidents on learners' satisfaction in e-learning. In particular, frequent occurrence of negative critical incidents has significant…

Ethical Dilemmas of Turkish Counsellors: A Critical Incidents Study

Science.gov (United States)

Sivis-Cetinkaya, Rahsan

2015-01-01

Ethical dilemmas from a national purposive sample of Turkish counsellors (N = 172) were collected using critical incidents technique. Content analysis was performed with open coding guided by the classification of American Counseling Association code of ethics. Incidents regarding confidentiality and privacy (56.4%), with 37.1% involving incidents…

EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

Science.gov (United States)

DeFraia, Gary S

2013-01-01

Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

The non-technical skills used by anaesthetic technicians in critical incidents reported to the Australian Incident Monitoring System between 2002 and 2008.

Science.gov (United States)

Rutherford, J S; Flin, R; Irwin, A

2015-07-01

The outcome of critical incidents in the operating theatre has been shown to be influenced by the behaviour of anaesthetic technicians (ATs) assisting anaesthetists, but the specific non-technical skills involved have not been described. We performed a review of critical incidents (n=1433) reported to the Australian Incident Monitoring System between 2002 and 2008 to identify which non-technical skills were used by ATs. The reports were assessed if they mentioned anaesthetic assistance or had the boxes ticked to identify "inadequate assistance" or "absent supervision or assistance". A total of 90 critical incidents involving ATs were retrieved, 69 of which described their use of non-technical skills. In 20 reports, the ATs ameliorated the critical incident, whilst in 46 they exacerbated the critical incident, and three cases had both positive and negative non-technical skills described. Situation awareness was identified in 39 reports, task management in 23, teamwork in 21 and decision-making in two, but there were no descriptions of issues related to leadership, stress or fatigue management. Situation awareness, task management and teamwork appear to be important non-technical skills for ATs in the development or management of critical incidents in the operating theatre. This analysis has been used to support the development of a non-technical skills taxonomy for anaesthetic assistants.

Surgery resident selection and evaluation. A critical incident study.

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Edwards, J C; Currie, M L; Wade, T P; Kaminski, D L

1993-03-01

This article reports a study of the process of selecting and evaluating general surgery residents. In personnel psychology terms, a job analysis of general surgery was conducted using the Critical Incident Technique (CIT). The researchers collected 235 critical incidents through structured interviews with 10 general surgery faculty members and four senior residents. The researchers then directed the surgeons in a two-step process of sorting the incidents into categories and naming the categories. The final essential categories of behavior to define surgical competence were derived through discussion among the surgeons until a consensus was formed. Those categories are knowledge/self-education, clinical performance, diagnostic skills, surgical skills, communication skills, reliability, integrity, compassion, organization skills, motivation, emotional control, and personal appearance. These categories were then used to develop an interview evaluation form for selection purposes and a performance evaluation form to be used throughout residency training. Thus a continuum of evaluation was established. The categories and critical incidents were also used to structure the interview process, which has demonstrated increased interview validity and reliability in many other studies. A handbook for structuring the interviews faculty members conduct with applicants was written, and an interview training session was held with the faculty. The process of implementation of the structured selection interviews is being documented currently through qualitative research.

The Critical Incident Interview and Ethnoracial Identity.

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Montalvo, Frank F.

1999-01-01

Describes the critical-incident interview, a cross-cultural training technique that helps social work students assess clients' ethnic- and racial-identity development. Uses examples from student interviews to present the steps involved in teaching the technique. Includes guidelines for selecting and interviewing informants, and gives three scales…

Critical incidents connected to nurses’ leadership in Intensive Care Units

Directory of Open Access Journals (Sweden)

Elaine Cantarella Lima

Full Text Available ABSTRACT Objective: The goal of this study is to analyze nurses’ leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents. Method: Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark. Results: Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses’ behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses’ activities; people management; and the setting of high quality care targets. Final considerations: Researchers identified a mixed leadership model, leading them to the conclusion that nurses’ knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization’s results.

Emergency and crisis management: critical incident stress management for first responders and business organisations.

Science.gov (United States)

Guenthner, Daniel H

2012-01-01

A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.

Entrepreneurial behavior : New perspectives gained through the critical incident technique

NARCIS (Netherlands)

Nandram, S.S.; Samsom, K.J.

2007-01-01

Responding to criticism of the trait approach in studying entrepreneurship, a process and context oriented methodology was applied using the Critical Incident Technique (CIT) in predicting success and failure. The actions of entrepreneurs were subsequently translated into (1) dynamic traits with a

The design of a new criticality incident detection and alarm system

International Nuclear Information System (INIS)

Nobes, T.S.

1999-01-01

This paper presents a general review of criticality and its detection. After a brief description of what a criticality incident involves, an outline is given of detection methods and warning systems. (author)

Using the Critical Incident Technique for Triangulation and Elaboration of Communication Management Competencies

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Brunton, Margaret Ann; Jeffrey, Lynn Maud

2010-01-01

This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…

A self-report critical incident assessment tool for army night vision goggle helicopter operations.

Science.gov (United States)

Renshaw, Peter F; Wiggins, Mark W

2007-04-01

The present study sought to examine the utility of a self-report tool that was designed as a partial substitute for a face-to-face cognitive interview for critical incidents involving night vision goggles (NVGs). The use of NVGs remains problematic within the military environment, as these devices have been identified as a factor in a significant proportion of aircraft accidents and incidents. The self-report tool was structured to identify some of the cognitive features of human performance that were associated with critical incidents involving NVGs. The tool incorporated a number of different levels of analysis, ranging from specific behavioral responses to broader cognitive constructs. Reports were received from 30 active pilots within the Australian Army using the NVG Critical Incident Assessment Tool (NVGCIAT). The results revealed a correspondence between specific types of NVG-related errors and elements of the Human Factors Analysis and Classification System (HFACS). In addition, uncertainty emerged as a significant factor associated with the critical incidents that were recalled by operators. These results were broadly consistent with previous research and provide some support for the utility of subjective assessment tools as a means of extracting critical incident-related data when face-to-face cognitive interviews are not possible. In some circumstances, the NVGCIAT might be regarded as a substitute cognitive interview protocol with some level of diagnosticity.

From novice to proficient general practitioner: a critical incident study.

Science.gov (United States)

Sim, M G; Kamien, M; Diamond, M R

1996-09-01

To obtain information about any change in the performance or perceptions of doctors undertaking the Royal Australian College of General Practitioners (RACGP) Training Program, with advancing general practice experience. The critical incident technique' was used, which is a comparative qualitative analysis. It involved interviews at 12 to 18 months after the basic term interview. Eighteen Western Australian doctors, who had been interviewed in 1992, at the end of their first 6 months of general practice training and were now completing their advanced or mentor terms in the RACGP Training Program took part in the study. Doctors reported an average of 4.4 critical incidents in their first interview and 5.0 in their second interview. The major areas of positive change included relationships with patients and other health care professionals, including supervisors; paediatrics and orthopaedics skills; the skills of developing a therapeutic relationship to enhance patient compliance and the ability to manage complex cardiovascular and psychiatric problems without reliance on specialist referral; attitudes of responsibility for and enjoyment of long term care of patients and families; and reduced levels of anxiety over difficult problems. New or continuing areas of difficulty were found in gynaecology; pharmacotherapy and dermatology; the diagnosis of common complaints with uncommon presentations; the skill of managing difficult or angry patients; the organisation for the follow-up of patients with potentially severe disorders; and in managing feelings of guilt over missed diagnoses or poor management. An analysis of commonly occurring positive and negative critical incidents shows that RACGP Training Program doctors develop competence, confidence and reduced levels of performance anxiety with advancing experience. All but one doctor found the Training Program helpful in achieving these proficiencies. However, many ongoing areas of difficulty remain. The Critical Incident

Extended incident-angle dependence formula of sputter yield

International Nuclear Information System (INIS)

Ono, T.; Shibata, K.; Muramoto, T.; Kenmotsu, T.; Li Z.; Kawamura, T.

2006-06-01

We extend a new semi-empirical formula for incident-angle dependence of normalized sputter yield that includes the contribution to sputter yield from the direct knock-out process that was not considered in the previously proposed one. Three parameters included in the new one are estimated for data calculated with ACAT code for D + ions incident obliquely on C, Fe and W materials in incident-energy regions from several tens of eV to 10 keV. Then, the parameters are expressed with functions of incident energy. The formula with the functions derived well reproduces that using the ACAT data in the whole energy range. (author)

Critical incidents in headteachers’ professional paths

Directory of Open Access Journals (Sweden)

Jurema Silvia de Souza Alves

2015-11-01

Full Text Available School management is considered one of the greatest challenges in achieving quality standards in contemporary education. Understanding the path of its main protagonist, the manager, living in a time and context that is different from those in which he/she acts, is essential to guide continued career management as well as to re-advise the initial career of teachersand future managers. In order to contribute to this knowledge, we present the result of a biographical-narrative research project that seeks to identify the critical incidents present in the professional lives of school managers from a medium-sized municipality in São Paulo state, Brazil. The answers to a questionnaire made it possible to characterize 25 managers, 32 of which being from school units in the city, and to select nine for interview. The interviews, which were transcribed and organized into biograms, showed that these professionals, mostly women, unlike the men surveyed, did not direct their careers to a role in management. Most of the regular critical incidents on their professional paths refer to the influence of supervisors who recommended them or encouraged them to study for admission tests related to management; the birth of their children, which motivated them to progress in their careers and/or promoting a break for future investment; their initial training, for many the Faculty of Education, was considered by participants as being insufficient for a role in management. It is considered that the career in management must be intensified as a continued career and be revised/altered from its initial background, so that managing activities correspond to the objectives of a high quality education.

Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare.

Science.gov (United States)

Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim

2014-07-01

In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

A critical incident study of general practice trainees in their basic general practice term.

Science.gov (United States)

Diamond, M R; Kamien, M; Sim, M G; Davis, J

1995-03-20

To obtain information on the experiences of general practice (GP) trainees during their first general practice (GP) attachment. Critical incident technique--a qualitative analysis of open-ended interviews about incidents which describe competent or poor professional practice. Thirty-nine Western Australian doctors from the Royal Australian College of General Practitioners' (RACGP) Family Medicine Program who were completing their first six months of general practice in 1992. Doctors reported 180 critical incidents, of which just over 50% involved problems (and sometimes successes) with: difficult patients; paediatrics; the doctor-patient relationship; counselling skills; obstetrics and gynaecology; relationships with other health professionals and practice staff; and cardiovascular disorders. The major skills associated with both positive and negative critical incidents were: the interpersonal skills of rapport and listening; the diagnostic skills of thorough clinical assessment and the appropriate use of investigations; and the management skills of knowing when and how to obtain help from supervisors, hospitals and specialists. Doctors reported high levels of anxiety over difficult management decisions and feelings of guilt over missed diagnoses and inadequate management. The initial GP term is a crucial transition period in the development of the future general practitioner. An analysis of commonly recurring positive and negative critical incidents can be used by the RACGP Training Program to accelerate the learning process of doctors in vocational training and has implications for the planning of undergraduate curricula.

Consequences attributed to kidney transplantation: critical incident technique

OpenAIRE

Santos,Bianca Pozza dos; Schwartz,Eda; Beuter,Margrid; Muniz,Rosani Manfrin; Echevarría-Guanilo,Maria Elena; Viegas,Aline da Costa

2015-01-01

This study aimed to describe the consequences experienced in the life of a person with kidney transplantation. This is a descriptive and qualitative approach, using the Critical Incident Technique, in which the interview content was analyzed, in an attempt to isolate the consequences of the kidney transplantation, showing positive and/or negative references. When confronted with what kidney transplantation provided to people's life, the independence from the hemodialysis machine, the existenc...

[Second victim : Critical incident stress management in clinical medicine].

Science.gov (United States)

Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A

2013-09-01

Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

Critical Incidents of Transnational Student-Teachers in Central Mexico

Science.gov (United States)

Serna-Gutiérrez, José Irineo Omar; Mora-Pablo, Irasema

2018-01-01

This study is an exploration of the life-changing decisions and changes which the participants underwent, and which led them to pursue an education in English language teaching (or languages). The foremost objective of this study was to highlight the critical incidents from the past, present, and teaching practice of transnational students in a BA…

Living in critical times: The impact of critical incidents on frontline ambulance personnel--a qualitative perspective.

LENUS (Irish Health Repository)

Gallagher, Sharon

2007-01-01

Little is known about the impact of Critical Incidents (CIs) on the lives of ambulance personnel. One-to-one interviews were conducted with 27 participants who had experienced CIs during the previous 12 months in order to: assess the nature and impact of CIs on health and well-being; examine attitudes toward support services; and explore barriers to service use. The results showed that incidents involving children, suicides, and grotesque mutilation were the most distressing. Participants reported a wide range of physical and mental health problems including sleep difficulties, angry outbursts, irrationality and feelings of alienation. Key themes included: low support service uptake due to fears relating to confidentiality and machismo; a perceived lack of concern and support from management; and a need for professional counselling and stress awareness training. Emergency Medical Controllers (EMCs) also reported a number of difficulties unique to their role. The findings suggest that exposure to CIs has a significant impact on health and well-being; this has important implications for recognizing and appropriately addressing the health and training needs of ambulance personnel, including the effective management of Critical Incident Stress.

Critical infrastructure dependencies 1-0-1

NARCIS (Netherlands)

Luiijf, H.A.M.; Nieuwenhuijs, A.H.; Klaver, M.H.A.

2008-01-01

Most of our critical infrastructures consist of complex systems-of-systems that provide services or products. The coupling mechanism between the chained systems in such complex systems of systems is dependencies. Dependencies may propagate cascading failures. Most studies on dependencies in

Critical incidents and the impact of satisfaction on customer share

NARCIS (Netherlands)

van Doorn, J.; Verhoef, P.C.

In business markets, the long-term nature of relationships may prompt parties to conduct "business as usual," but negative critical incidents (CIs) can cause a destabilization of these long-term relationships. The authors develop a comprehensive dynamic model of customer loyalty to account for the

Exploring reflective 'critical incident' documentation of professionalism lapses in a medical undergraduate setting

Directory of Open Access Journals (Sweden)

McLachlan John C

2009-07-01

Full Text Available Abstract Background Measuring professionalism in undergraduate medical students is a difficult process, and no one method has currently emerged as the definitive means of assessment in this field. Student skills in reflection have been shown to be highly important in the development of professional behaviours. By studying student reflections on lapses in professional judgement, recorded as 'critical incidents', it is possible to explore themes which are significant for the development of professional behaviour in an undergraduate setting. Methods We examined critical incident reporting combined with optional written student reflection as a method for exploring professionalism in undergraduate medical students. 228 students split between Year 1 and 2 of one academic year of undergraduate medicine were studied retrospectively and a grounded theory approach to analysis was employed. Results This year generated 16 critical incident reports and corresponding student reflections, all of which were considered. In addition to identifying the nature of the critical incidents, 3 principal themes emerged. These were the impact and consequences of the report having been made, student reactions to the events (both positive and negative, and student responses regarding future actions. Conclusion This study indicates that unprofessional behaviour can be identified and challenged by both the faculty and the students involved, and suggests that positive behavioural changes might be made with the aim of preventing future occurrences. We provide a low cost approach of measuring and recording professional behaviour.

In situ simulation: Taking reported critical incidents and adverse events back to the clinic

DEFF Research Database (Denmark)

Juul, Jonas; Paltved, Charlotte; Krogh, Kristian

2014-01-01

for content analysis4 and thematic analysis5. Medical experts and simulation faculty will design scenarios for in situ simulation training based on the analysis. Short-term observations using time logs will be performed along with interviews with key informants at the departments. Video data will be collected...... improve patient safety if coupled with training and organisational support2. Insight into the nature of reported critical incidents and adverse events can be used in writing in situ simulation scenarios and thus lead to interventions that enhance patient safety. The patient safety literature emphasises...... well-developed non-technical skills in preventing medical errors3. Furthermore, critical incidents and adverse events reporting systems comprise a knowledgebase to gain in-depth insights into patient safety issues. This study explores the use of critical incidents and adverse events reports to inform...

Health and productivity of commuter railroad employees involved in critical incidents.

Science.gov (United States)

2011-02-15

ABSTRACTThe effects of accidentstermed Critical Incidentson the health and productivity of rail transit workers have not been fully investigated. Anecdotal evidence suggests lasting effects of these incidents. Surveys were obtained from 363 com...

Normal-incidence spectroscopic ellipsometry for critical dimension monitoring

International Nuclear Information System (INIS)

Huang, Hsu-Ting; Kong, Wei; Terry, Fred Lewis

2001-01-01

In this letter, we show that normal-incidence spectroscopic ellipsometry can be used for high-accuracy topography measurements on surface relief gratings. We present both experimental and theoretical results which show that spectroscopic ellipsometry or reflectance-difference spectroscopy at near-normal incidence coupled with vector diffraction theory for data analysis is capable of high-accuracy critical dimension (CD), feature height, and sidewall angle measurements in the extreme submicron regime. Quantitative comparisons of optical and cross-sectional scanning electron microscopy (SEM) topography measurements from a number of 350 nm line/space reactive-ion-etched Si gratings demonstrate the strong potential for in situ etching monitoring. This technique can be used for both ex situ and in situ applications and has the potential to replace the use of CD-SEM measurements in some applications. [copyright] 2001 American Institute of Physics

Skin bank development and critical incident response.

Science.gov (United States)

Hamilton, Kellie T; Herson, Marisa R

2011-05-01

The Donor Tissue Bank of Victoria (DTBV), situated in Melbourne, Australia developed a skin banking program in 1994. It remains Australia's only operational skin bank, processing cryopreserved human cadaveric skin for the treatment of burns. The demand for allograft skin in Australia has steadily increased since the development of the program. The bank has been involved in the provision of skin for a number of critical incidences or disasters both in Australia and overseas. Demand always exceeds supply, and in the absence of other local skin banks, the DTBV has needed to develop strategies to enable increased provision of allograft skin nationally.

Critical Incidents of Growth in Nordic eHealth Service Start-Ups

Directory of Open Access Journals (Sweden)

Martti Saarela

2017-06-01

Full Text Available Digitalisation can revolutionise healthcare delivery and provide new business opportunities for innovative start-ups. Start-up businesses in the healthcare service sector are a promising source of new employment and innovations. The start-up stage is the most critical period for the survival of a business, as decisions made during the early stages have a definitive influence on success. This study seeks to clarify the early development of eHealth service start-ups. To summarise the research problem, the authors ask the following question: What are the critical incidents related to the early development of eHealth service start-ups? The units of analysis in this study are 14 Nordic eHealth service start-ups located in Sweden and Finland. The Critical Incident Technique (CIT and semi-structured interviews were applied for data collection. The results are of interest to the public sector, which plays an essential role in healthcare as a service producer, but also as a creator of the business conditions of and opportunities for small businesses.

The Critical Incident Technique in Library and Information Management Research.

Science.gov (United States)

Fisher, Shelagh; Oulton, Tony

1999-01-01

Focuses on the application of the Critical Incident Technique (CIT) in three studies at the Department of Information and Communications, Manchester Metropolitan University, United Kingdom. Examines staff-development needs as a key element in change in higher education; decision-making practices in small- to medium-size libraries; and development…

Education for Ethically Sensitive Teaching in Critical Incidents at School

Science.gov (United States)

Hanhimaki, Eija; Tirri, Kirsi

2009-01-01

The purpose of the present study was to identify and investigate critical incidents at school that require ethically sensitive teaching. This kind of knowledge is needed in teacher education to prepare future teachers for their profession. The data included narrative interviews with 12 teachers from four urban schools in Finland. Critical…

Critical incidents during prehospital cardiopulmonary resuscitation: what are the problems nobody wants to talk about?

Science.gov (United States)

Hohenstein, Christian; Rupp, Peter; Fleischmann, Thomas

2011-02-01

We wanted to identify incidents that led or could have led to patient harm during prehospital cardiopulmonary resuscitation. A nationwide anonymous and Internet-based critical incident reporting system gave the data. During a 4-year period we received 548 reports of which 74 occurred during cardiopulmonary resuscitation. Human error was responsible for 85% of the incidents, whereas equipment failure contributed to 15% of the reports. Equipment failure was considered to be preventable in 61% of all the cases, whereas incidents because of human error could have been prevented in almost all the cases. In most cases, prevention can be accomplished by simple strategies with the Poka-Yoke technique. Insufficient training of emergency medical service physicians in Germany requires special attention. The critical incident reports raise concerns regarding the level of expertize provided by emergency medical service doctors.

Incident energy dependence of pt correlations at relativistic energies

CERN Document Server

Adams, J; Ahammed, Z; Amonett, J; Anderson, B D; Arkhipkin, D; Averichev, G S; Badyal, S K; Bai, Y; Balewski, J; Barannikova, O; Barnby, L S; Baudot, J; Bekele, S; Belaga, V V; Bellingeri-Laurikainen, A; Bellwied, R; Berger, J; Bezverkhny, B I; Bharadwaj, S; Bhasin, A; Bhati, A K; Bhatia, V S; Bichsel, H; Bielcik, J; Bielcikova, J; Billmeier, A; Bland, L C; Blyth, C O; Bonner, B E; Botje, M; Boucham, A; Bouchet, J; Brandin, A V; Bravar, A; Bystersky, M; Cadman, R V; Cai, X Z; Caines, H; Calderón de la Barca-Sanchez, M; Castillo, J; Catu, O; Cebra, D; Chajecki, Z; Chaloupka, P; Chattopadhyay, S; Chen, H F; Chen, Y; Cheng, J; Cherney, M; Chikanian, A; Christie, W; Coffin, J P; Cormier, T M; Cramer, J G; Crawford, H J; Das, D; Das, S; Daugherity, M; De Moura, M M; Dedovich, T G; Derevshchikov, A A; Didenko, L; Dietel, T; Dogra, S M; Dong, W J; Dong, X; Draper, J E; Du, F; Dubey, A K; Dunin, V B; Dunlop, J C; Dutta, M R; Mazumdar; Eckardt, V; Edwards, W R; Efimov, L G; Emelianov, V; Engelage, J; Eppley, G; Erazmus, B; Estienne, M; Fachini, P; Faivre, J; Fatemi, R; Fedorisin, J; Filimonov, K; Filip, P; Finch, E; Fine, V; Fisyak, Yu; Fu, J; Gagliardi, C A; Gaillard, L; Gans, J; Ganti, M S; Geurts, F; Ghazikhanian, V; Ghosh, P; González, J E; Gos, H; Grachov, O; Grebenyuk, O; Grosnick, D P; Guertin, S M; Guo, Y; Sen-Gupta, A; Gutíerrez, T D; Hallman, T J; Hamed, A; Hardtke, D; Harris, J W; Heinz, M; Henry, T W; Hepplemann, S; Hippolyte, B; Hirsch, A; Hjort, E; Hoffmann, G W; Huang, H Z; Huang, S L; Hughes, E W; Humanic, T J; Igo, G; Ishihara, A; Jacobs, P; Jacobs, W W; Jedynak, M; Jiang, H; Jones, P G; Judd, E G; Kabana, S; Kang, K; Kaplan, M; Keane, D; Kechechyan, A; Khodyrev, V Yu; Kiryluk, J; Kisiel, A; Kislov, E M; Klay, J; Klein, S R; Koetke, D D; Kollegger, T; Kopytine, M; Kotchenda, L; Kowalik, K L; Krämer, M; Kravtsov, P; Kravtsov, V I; Krüger, K; Kuhn, C; Kulikov, A I; Kumar, A; Kutuev, R K; Kuznetsov, A A; Lamont, M A C; Landgraf, J M; Lange, S; Laue, F; Lauret, J; Lebedev, A; Lednicky, R; Lehocka, S; Le Vine, M J; Li, C; Li, Q; Li, Y; Lin, G; Lindenbaum, S J; Lisa, M A; Liu, F; Liu, H; Liu, L; Liu, Q J; Liu, Z; Ljubicic, T; Llope, W J; Long, H; Longacre, R S; López-Noriega, M; Love, W A; Lu, Y; Ludlam, T; Lynn, D; Ma, G L; Ma, J G; Ma, Y G; Magestro, D; Mahajan, S; Mahapatra, D P; Majka, R; Mangotra, L K; Manweiler, R; Margetis, S; Markert, C; Martin, L; Marx, J N; Matis, H S; Matulenko, Yu A; McClain, C J; McShane, T S; Meissner, F; Melnik, Yu M; Meschanin, A; Miller, M L; Minaev, N G; Mironov, C; Mischke, A; Mishra, D K; Mitchell, J; Mohanty, B; Molnár, L; Moore, C F; Morozov, D A; Munhoz, M G; Nandi, B K; Nayak, S K; Nayak, T K; Nelson, J M; Netrakanti, P K; Nikitin, V A; Nogach, L V; Nurushev, S B; Odyniec, Grazyna Janina; Ogawa, A; Okorokov, V; Oldenburg, M; Olson, D; Pal, S K; Panebratsev, Yu A; Panitkin, S Y; Pavlinov, A I; Pawlak, T; Peitzmann, T; Perevozchikov, V; Perkins, C; Peryt, W; Petrov, V A; Phatak, S C; Picha, R; Planinic, M; Pluta, J; Porile, N; Porter, J; Poskanzer, A M; Potekhin, M V; Potrebenikova, E V; Potukuchi, B V K S; Prindle, D; Pruneau, C A; Putschke, J; Rakness, G; Raniwala, R; Raniwala, S; Ravel, O; Ray, R L; Razin, S V; Reichhold, D M; Reid, J G; Reinnarth, J; Renault, G; Retière, F; Ridiger, A; Ritter, H G; Roberts, J B; Rogachevski, O V; Romero, J L; Rose, A; Roy, C; Ruan, L; Russcher, M; Sahoo, R; Sakrejda, I; Salur, S; Sandweiss, J; Sarsour, M; Savin, I; Sazhin, P S; Schambach, J; Scharenberg, R P; Schmitz, N; Schweda, K; Seger, J; Seyboth, P; Shahaliev, E; Shao, M; Shao, W; Sharma, M; Shen, W Q; Shestermanov, K E; Shimansky, S S; Sichtermann, E P; Simon, F; Singaraju, R N; Smirnov, N; Snellings, R; Sood, G; Sørensen, P; Sowinski, J; Speltz, J; Spinka, H M; Srivastava, B; Stadnik, A; Stanislaus, T D S; Stock, R; Stolpovsky, A; Strikhanov, M N; Stringfellow, B C; Suaide, A A P; Sugarbaker, E R; Suire, C; Sumbera, M; Surrow, B; Swanger, M; Symons, T J M; Szanto de Toledo, A; Tai, A; Takahashi, J; Tang, A H; Tarnowsky, T J; Thein, D; Thomas, J H; Timoshenko, S; Tokarev, M; Trentalange, S; Tribble, R E; Tsai, O D; Ulery, J; Ullrich, T; Underwood, D G; Van Buren, G; Van Leeuwen, M; Van der Molen, A M; Varma, R; Vasilevski, I M; Vasilev, A N; Vernet, R; Vigdor, S E; Viyogi, Y P; Vokal, S; Voloshin, S A; Waggoner, W T; Wang, F; Wang, G; Wang, X L; Wang, Y; Wang, Z M; Ward, H; Watson, J W; Webb, J C; Westfall, G D; Wetzler, A; Whitten, C; Wieman, H; Wissink, S W; Witt, R; Wood, J; Wu, J; Xu, N; Xu, Z; Xu, Z Z; Yamamoto, E; Yepes, P; Yurevich, V I; Zborovský, I; Zhang, H; Zhang, W M; Zhang, Y; Zhang, Z P; Zoulkarneev, R; Zoulkarneeva, Y; Zubarev, A N

2005-01-01

We present results for two-particle transverse momentum correlations, , as a function of event centrality for Au+Au collisions at sqrt(sNN) = 20, 62, 130, and 200 GeV at the Relativistic Heavy Ion Collider. We observe correlations decreasing with centrality that are similar at all four incident energies. The correlations multiplied by the multiplicity density increase with incident energy and the centrality dependence may show evidence of processes such as thermalization, minijet production, or the saturation of transverse flow. The square root of the correlations divided by the event-wise average transverse momentum per event shows little or no beam energy dependence and generally agrees with previous measurements at the Super Proton Synchrotron.

Dependence of extinction cross-section on incident polarization state and particle orientation

International Nuclear Information System (INIS)

Yang Ping; Wendisch, Manfred; Bi Lei; Kattawar, George; Mishchenko, Michael; Hu, Yongxiang

2011-01-01

This note reports on the effects of the polarization state of an incident quasi-monochromatic parallel beam of radiation and the orientation of a hexagonal ice particle with respect to the incident direction on the extinction process. When the incident beam is aligned with the six-fold rotational symmetry axis, the extinction is independent of the polarization state of the incident light. For other orientations, the extinction cross-section for linearly polarized light can be either larger or smaller than its counterpart for an unpolarized incident beam. Therefore, the attenuation of a quasi-monochromatic radiation beam by an ice cloud depends on the polarization state of the beam if ice crystals within the cloud are not randomly oriented. Furthermore, a case study of the extinction of light by a quartz particle is also presented to illustrate the dependence of the extinction cross-section on the polarization state of the incident light.

The influence of anaesthetists' experience on workload, performance and visual attention during simulated critical incidents.

Science.gov (United States)

Schulz, Christian M; Schneider, Erich; Kohlbecher, Stefan; Hapfelmeier, Alexander; Heuser, Fabian; Wagner, Klaus J; Kochs, Eberhard F; Schneider, Gerhard

2014-10-01

Development of accurate Situation Awareness (SA) depends on experience and may be impaired during excessive workload. In order to gain adequate SA for decision making and performance, anaesthetists need to distribute visual attention effectively. Therefore, we hypothesized that in more experienced anaesthetists performance is better and increase of physiological workload is less during critical incidents. Additionally, we investigated the relation between physiological workload indicators and distribution of visual attention. In fifteen anaesthetists, the increase of pupil size and heart rate was assessed in course of a simulated critical incident. Simulator log files were used for performance assessment. An eye-tracking device (EyeSeeCam) provided data about the anaesthetists' distribution of visual attention. Performance was assessed as time until definitive treatment. T tests and multivariate generalized linear models (MANOVA) were used for retrospective statistical analysis. Mean pupil diameter increase was 8.1% (SD ± 4.3) in the less experienced and 15.8% (±10.4) in the more experienced subjects (p = 0.191). Mean heart rate increase was 10.2% (±6.7) and 10.5% (±8.3, p = 0.956), respectively. Performance did not depend on experience. Pupil diameter and heart rate increases were associated with a shift of visual attention from monitoring towards manual tasks (not significant). For the first time, the following four variables were assessed simultaneously: physiological workload indicators, performance, experience, and distribution of visual attention between "monitoring" and "manual" tasks. However, we were unable to detect significant interactions between these variables. This experimental model could prove valuable in the investigation of gaining and maintaining SA in the operation theatre.

[Analysis of an incident notification system and register in a critical care unit].

Science.gov (United States)

Murillo-Pérez, M A; García-Iglesias, M; Palomino-Sánchez, I; Cano Ruiz, G; Cuenca Solanas, M; Alted López, E

2016-01-01

To analyse the incident communicated through a notification system and register in a critical care unit. A cross-sectional descriptive study was conducted by performing an analysis of the records of incidents communicated anonymously and voluntarily from January 2007 to December 2013 in a critical care unit of adult patients with severe trauma. incident type and class, professional reports, and suggestions for improvement measures. A descriptive analysis was performed on the variables. Out of a total of 275 incidents reported, 58.5% of them were adverse events. Incident distributed by classes: medication, 33.7%; vascular access-drainage-catheter-sensor, 19.6%; devices-equipment, 13.3%, procedures, 11.5%; airway tract and mechanical ventilation, 10%; nursing care, 4.1%; inter-professional communication, 3%; diagnostic test, 3%; patient identification, 1.1%, and transfusion 0.7%. In the medication group, administrative errors accounted for a total of 62%; in vascular access-drainage-catheter-sensor group, central venous lines, a total of 27%; in devices and equipment group, respirators, a total of 46.9%; in airway self-extubations, a total of 32.1%. As regards to medication errors, 62% were incidents without damage. Incident notification by profession: doctors, 43%, residents, 5.6%, nurses, 51%, and technical assistants, 0.4%. Adverse events are the most communicated incidents. The events related to medication administration are the most frequent, although most of them were without damage. Nurses and doctors communicate the incidents with the same frequency. In order to highlight the low incident notification despite it being an anonymous and volunteer system, therefore, it is suggested to study measurements to increase the level of communication. Copyright © 2016 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Dependency and self-criticism in treatments for depression.

Science.gov (United States)

Chui, Harold; Zilcha-Mano, Sigal; Dinger, Ulrike; Barrett, Marna S; Barber, Jacques P

2016-07-01

Dependency and self-criticism are vulnerability factors for depression. How these personality factors change with treatment for depression and how they relate to symptom change across different types of treatment require further research. In addition, cultural differences that interact with the dependency/self-criticism-depression relation remain underinvestigated. We randomly assigned 149 adults with major depression to receive active medication (MED; n = 50), supportive-expressive therapy (SET; n = 49), or placebo pill (PBO; n = 50). Participants completed the Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan, 1976) before and after treatment and completed the Hamilton Rating Scale for Depression (Hamilton, 1967) throughout the course of treatment. Self-criticism as measured on the DEQ decreased with treatment similarly across conditions. DEQ Dependency decreased in MED but remained unchanged in SET and PBO. Higher initial dependency, but not higher initial self-criticism, predicted poor treatment response across conditions. Greater reduction in self-criticism was associated with greater reduction in depressive symptoms, but the effect was weaker for racial minorities (vs. White). Increase in connectedness, an adaptive form of dependency, was associated with symptom improvement in SET but not MED. Hence, different pathways of change seem to be implicated in the treatment of depression depending on culture and type of intervention. Implications for future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Critical Age-Dependent Branching Markov Processes and their ...

Indian Academy of Sciences (India)

This paper studies: (i) the long-time behaviour of the empirical distribution of age and normalized position of an age-dependent critical branching Markov process conditioned on non-extinction; and (ii) the super-process limit of a sequence of age-dependent critical branching Brownian motions.

Travel Behavior Change in Older Travelers: Understanding Critical Reactions to Incidents Encountered in Public Transport.

Science.gov (United States)

Sundling, Catherine

2015-11-18

Accessibility of travel may be better understood if psychological factors underlying change in travel behavior are known. This paper examines older (65+) travelers' motives for changing their travel behavior. These changes are grounded in critical incidents earlier encountered in public-transport travel. A scientific framework is developed based on cognitive and behavioral theory. In 29 individual interviews, travelers' critical reactions (i.e., cognitive, emotional, and/or behavioral) to 77 critical incidents were examined. By applying critical incident technique (CIT), five reaction themes were identified that had generated travel-behavior change: firm restrictions, unpredictability, unfair treatment, complicated trips, and earlier adverse experiences. To improve older travelers' access to public transport, key findings were: (a) service must be designed so as to strengthen the feeling of being in control throughout the journey; (b) extended personal service would increase predictability in the travel chain and decrease travel complexity; consequently, (c) when designing new services and making effective accessibility interventions, policy makers should consider and utilize underlying psychological factors that could direct traveler behavior.

Travel Behavior Change in Older Travelers: Understanding Critical Reactions to Incidents Encountered in Public Transport

Directory of Open Access Journals (Sweden)

Catherine Sundling

2015-11-01

Full Text Available Accessibility of travel may be better understood if psychological factors underlying change in travel behavior are known. This paper examines older (65+ travelers’ motives for changing their travel behavior. These changes are grounded in critical incidents earlier encountered in public-transport travel. A scientific framework is developed based on cognitive and behavioral theory. In 29 individual interviews, travelers’ critical reactions (i.e., cognitive, emotional, and/or behavioral to 77 critical incidents were examined. By applying critical incident technique (CIT, five reaction themes were identified that had generated travel-behavior change: firm restrictions, unpredictability, unfair treatment, complicated trips, and earlier adverse experiences. To improve older travelers’ access to public transport, key findings were: (a service must be designed so as to strengthen the feeling of being in control throughout the journey; (b extended personal service would increase predictability in the travel chain and decrease travel complexity; consequently, (c when designing new services and making effective accessibility interventions, policy makers should consider and utilize underlying psychological factors that could direct traveler behavior.

Travel Behavior Change in Older Travelers: Understanding Critical Reactions to Incidents Encountered in Public Transport

Science.gov (United States)

Sundling, Catherine

2015-01-01

Accessibility of travel may be better understood if psychological factors underlying change in travel behavior are known. This paper examines older (65+) travelers’ motives for changing their travel behavior. These changes are grounded in critical incidents earlier encountered in public-transport travel. A scientific framework is developed based on cognitive and behavioral theory. In 29 individual interviews, travelers’ critical reactions (i.e., cognitive, emotional, and/or behavioral) to 77 critical incidents were examined. By applying critical incident technique (CIT), five reaction themes were identified that had generated travel-behavior change: firm restrictions, unpredictability, unfair treatment, complicated trips, and earlier adverse experiences. To improve older travelers’ access to public transport, key findings were: (a) service must be designed so as to strengthen the feeling of being in control throughout the journey; (b) extended personal service would increase predictability in the travel chain and decrease travel complexity; consequently, (c) when designing new services and making effective accessibility interventions, policy makers should consider and utilize underlying psychological factors that could direct traveler behavior. PMID:26593935

Angular momentum and incident-energy dependence of nucleus-nucleus interaction

International Nuclear Information System (INIS)

Yamaguchi, S.

1991-01-01

The purpose of this paper is to understand intuitively the origin of the angular momentum and incident-energy dependence of the nucleus-nucleus interaction on the basis of the totally- antisymmetrized many-body theory. With the aim of understanding the structure of the nucleus-nucleus interaction, we show first that the nucleus-nucleus interaction can be written by the use of the density-distribution function and the phase-space distribution function instead of using the many-body wave function itself. And we show that the structure change of the density-distribution function with the increase of the angular momentum causes the angular momentum dependence of the nucleus-nucleus interaction and that the incident-energy dependence of the nucleus-nucleus interaction originates from the structure change of the phase-space distribution function

Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues

Science.gov (United States)

Ward, C L; Lombard, C J; Gwebushe, N

2006-01-01

Objectives To assess critical incident exposure among prehospital emergency services personnel in the developing world context of South Africa; and to assess associated mental health consequences. Methods We recruited a representative sample from emergency services in the Western Cape Province, South Africa, to participate in this cross sectional epidemiological study. Questionnaires covered critical incident exposure, general psychopathology, risky alcohol use, symptoms of post‐traumatic stress disorder (PTSD), and psychological and physical aggression between co‐workers. Open ended questions addressed additional stressors. Results Critical incident exposure and rates of general psychopathology were higher than in studies in the developed world. Exposure to critical incidents was associated with general psychopathology, symptoms of PTSD, and with aggression between co‐workers, but not with alcohol use. Ambulance, fire, and sea rescue services had lower general psychopathology scores than traffic police. The sea rescue service also scored lower than traffic police on PTSD and psychological aggression. The defence force had higher rates of exposure to physical assault, and in ambulance services, younger staff were more vulnerable to assault. Women had higher rates of general psychopathology and of exposure to psychological aggression. Other stressors identified included death notification, working conditions, and organisational problems. Conclusions Service organisations should be alert to the possibility that their personnel are experiencing work ‐related mental health and behavioural problems, and should provide appropriate support. Attention should also be given to organisational issues that may add to the stress of incidents. Workplace programmes should support vulnerable groups, and address death notification and appropriate expression of anger. PMID:16498167

Giibinenimidizomin: Owning Ourselves--Critical Incidents in the Attainment of Aboriginal Identity

Science.gov (United States)

Goodwill, Alanaise O.; McCormick, Rod

2012-01-01

This research explored the facilitation and hindrance of Aboriginal identity attainment and developed a scheme of categories to describe what facilitates and hinders cultural identity among Canadian Aboriginal adults living in British Columbia. Twelve individuals, interviewed using the critical incident technique, were asked to describe observable…

Pilot Critical Incident Reports as a Means to Identify Human Factors of Remotely Piloted Aircraft

Science.gov (United States)

Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

2016-01-01

It has been estimated that aviation accidents are typically preceded by numerous minor incidents arising from the same causal factors that ultimately produced the accident. Accident databases provide in-depth information on a relatively small number of occurrences, however incident databases have the potential to provide insights into the human factors of Remotely Piloted Aircraft System (RPAS) operations based on a larger volume of less-detailed reports. Currently, there is a lack of incident data dealing with the human factors of unmanned aircraft systems. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. During each focus group session, a note taker produced a de-identified written record of the incident narratives. At the end of the session, participants reviewed each written incident report, and made edits and corrections as necessary. The incidents were later analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot during the events. A total of 90 incidents were reported. Human factor issues included the impact of reduced sensory cues, traffic separation in the absence of an out-the-window view, control latencies, vigilance during monotonous and ultra-long endurance flights, control station design considerations, transfer of control between control stations, the management of lost link procedures, and decision-making during emergencies. Pilots participated willingly and enthusiastically in the study

Polarization dependence in ELNES: Influence of probe convergence, collector aperture and electron beam incidence angle

International Nuclear Information System (INIS)

Le Bosse, J.C.; Epicier, T.; Jouffrey, B.

2006-01-01

The differential scattering cross section in electron energy loss near edge spectroscopy (ELNES) generally depends on the orientation of the Q wave vector transferred from the incident electron to an atomic core electron. In the case where the excited atom belongs to a threefold, fourfold or sixfold main rotation axis, the dipole cross section depends on the angle of Q with respect to this axis. In this paper, we restrict to this situation called dichroism. Furthermore, if we take into account the relativistic effects due to the high incident electron velocity, this dipole cross section also depends on the angle of Q with respect to the electron beam axis. It is due to these dependences that the shape of measured electron energy loss spectra varies with the electron beam incidence, the collector aperture, the incident beam convergence and the incident electron energy. The existence of a particular beam incidence angle for which the scattering cross section becomes independent of collection and beam convergence semi-angles is clearly underscored. Conversely, it is shown that EELS spectra do not depend on the beam incidence angle for a set of particular values of collection and convergence semi-angles. Particularly, in the case of a parallel incident beam, there is a collection semi-angle (often called magic angle) for which the cross section becomes independent of the beam orientation. This magic angle depends on the incident beam kinetic energy. If the incident electron velocity V is small compared with the light velocity c, this magic angle is about 3.975θ E (θ E is the scattering angle). It decreases to 0 when V approaches c. These results are illustrated in the case of the K boron edge in the boron nitride

Critical incidents connected to nurses' leadership in Intensive Care Units.

Science.gov (United States)

Lima, Elaine Cantarella; Bernardes, Andrea; Baldo, Priscila Lapaz; Maziero, Vanessa Gomes; Camelo, Silvia Helena Henriques; Balsanelli, Alexandre Pazetto

2017-01-01

The goal of this study is to analyze nurses' leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents. Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark. Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses' behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses' activities; people management; and the setting of high quality care targets. Researchers identified a mixed leadership model, leading them to the conclusion that nurses' knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization's results. Analisar a liderança do enfermeiro em Centros de Terapia Intensiva de hospitais localizados no interior do estado de São Paulo, diante de incidentes críticos positivos e negativos. Estudo exploratório, descritivo, realizado com 24 enfermeiros, que utilizou a Técnica do Incidente Crítico como referencial metodológico. Os resultados foram agrupados em 61 incidentes críticos distribuídos em categorias. Identificou-se que situações relacionadas à liderança interferem no comportamento do enfermeiro de Terapia Intensiva, dentre elas: dificuldade no processo de comunicação, conflitos existentes no dia a dia do exercício profissional, gerenciamento de pessoas e estabelecimento de metas para o alcance da assistência qualificada. Encontrou-se um modelo misto de liderança, o que permite concluir que o conhecimento e a prática dos enfermeiros acerca de teorias/estilos contemporâneos de liderança tornam-se fundamentais, pois

Unpacking In-Service EFL Teachers' Critical Incidents: The Case of Iran

Science.gov (United States)

Atai, Mahmood Reza; Nejadghanbar, Hassan

2016-01-01

Despite the importance of reflection on critical incidents (CIs), there are only a few studies in ELT literature addressing English language teachers' CIs (Farrell, 2008). Accordingly, this study was conducted to explore and discuss how six in-service EFL teachers reflected on and reported their CIs. In so doing, the participant teachers reflected…

Nuclear incident monitor criticality alarm instrument for the Savannah River Site: Technical manual

International Nuclear Information System (INIS)

Jenkins, J.B.

1996-01-01

The Savannah River Site is a Department of Energy facility. The facility stores, processes, and works with fissionable material at a number of locations. Technical standards and US Department of Energy orders, require these locations to be monitored by criticality alarm systems under certain circumstances. The Savannah River Site calls such instruments Nuclear Incident Monitors or NIMs. The Sole purpose of the Nuclear Incident Monitor is to provide an immediate evacuation signal in the case of an accidental criticality in order to minimize personnel exposure to radiation. The new unit is the third generation Nuclear Incident Monitor at the Savannah River Site. The second generation unit was developed in 1979. It was designed to eliminate vacuum-tube circuits, and was the first solid state NIM at SRS. The major design objectives of the second generation NIM were to improve reliability and reduce maintenance costs. Ten prototype units have been built and tested. This report describes the design of the new NIM and the testing that took place to verify its acceptability

Critical incidents and mortality reporting in pediatric anesthesia: the Australian experience.

Science.gov (United States)

Ragg, Philip

2011-07-01

Since 1960, the collection and analysis of mortality data for anesthesia in Australia has been of significant benefit to practising anesthetists. These figures include pediatric deaths which fortunately have been rare and often inevitable because of severe underlying disease and patient risk factors. The reporting of critical incidents and serious morbidity, on the other hand, has been far less impressive. Only one state in Australia, Victoria, currently has a committee that collects morbidity data and, as this reporting is voluntary, is likely to under-represent the true numbers of critical events. There is no specific pediatric morbidity database in Australia so much of this discussion will be regarding overall anesthesia critical event reporting which includes pediatrics as a subset. © 2011 Blackwell Publishing Ltd.

Survey to identify depth of penetration of critical incident reporting systems in Austrian healthcare facilities.

Science.gov (United States)

Sendlhofer, Gerald; Eder, Harald; Leitgeb, Karina; Gorges, Roland; Jakse, Heidelinde; Raiger, Marianne; Türk, Silvia; Petschnig, Walter; Pregartner, Gudrun; Kamolz, Lars-Peter; Brunner, Gernot

2018-01-01

Incident reporting systems or so-called critical incident reporting systems (CIRS) were first recommended for use in health care more than 15 years ago. The uses of these CIRS are highly variable among countries, ranging from being used to report critical incidents, falls, or sentinel events resulting in death. In Austria, CIRS have only been introduced to the health care sector relatively recently. The goal of this work, therefore, was to determine whether and specifically how CIRS are used in Austria. A working group from the Austrian Society for Quality and Safety in Healthcare (ASQS) developed a survey on the topic of CIRS to collect information on penetration of CIRS in general and on how CIRS reports are used to increase patient safety. Three hundred seventy-one health care professionals from 274 health care facilities were contacted via e-mail. Seventy-eight respondents (21.0%) completed the online survey, thereof 66 from hospitals and 12 from other facilities (outpatient clinics, nursing homes). In all, 64.1% of the respondents indicated that CIRS were used in the entire health care facility; 20.6% had not yet introduced CIRS and 15.4% used CIRS only in particular areas. Most often, critical incidents without any harm to patients were reported (76.9%); however, some health care facilities also use their CIRS to report patient falls (16.7%), needle stick injuries (17.9%), technical problems (51.3%), or critical incidents involving health care professionals. CIRS are not yet extensively or homogeneously used in Austria. Inconsistencies exist with respect to which events are reported as well as how they are followed up and reported to health care professionals. Further recommendations for general use are needed to support the dissemination in Austrian health care environments.

Development of a radiology faculty appraisal instrument by using critical incident interviewing.

Science.gov (United States)

Collins, J; Albanese, M A; Thakor, S K; Propeck, P A; Scanlan, K A

1997-12-01

To develop a valid and reliable radiology faculty appraisal instrument based on scientific methods. Fifteen radiology residents participated in critical incident interviewing. During a 1-hour interview, a resident was asked to describe five incidents each of effective and ineffective faculty behavior. Two investigators independently listened to the tape-recorded interviews, and two different investigators sorted the incidents into broad categories. A faculty appraisal instrument was developed by listing similar incidents under broad categories. A five-point rating scale was applied to each item. Content validity was assessed by resident and faculty critique of the appraisal instrument. A total of 168 incidents of faculty behavior were generated. The frequency with which similar incidents were reported was recorded. The most common behaviors reported were related to staff expertise and teaching. Interjudge reliability was good, as determined by computing K indices of agreement (overall K = 0.59). There was good agreement regarding instrument content validity among residents but not among faculty. Residents supported the use of the new appraisal instrument, but further tests of validity and reliability and faculty acceptance of the instrument will determine its usefulness as a tool for monitoring faculty teaching performance and making decisions regarding faculty promotion.

Analysis of incident-energy dependence of delayed neutron yields in actinides

Energy Technology Data Exchange (ETDEWEB)

Nasir, Mohamad Nasrun bin Mohd, E-mail: monasr211@gmail.com; Metorima, Kouhei, E-mail: kohei.m2420@hotmail.co.jp; Ohsawa, Takaaki, E-mail: ohsawa@mvg.biglobe.ne.jp; Hashimoto, Kengo, E-mail: kengoh@pp.iij4u.or.jp [Graduate School of Science and Engineering, Kindai University, Kowakae, Higashi-Osaka, 577-8502 (Japan)

2015-04-29

The changes of delayed neutron yields (ν{sub d}) of Actinides have been analyzed for incident energy up to 20MeV using realized data of precursor after prompt neutron emission, from semi-empirical model, and delayed neutron emission probability data (P{sub n}) to carry out a summation method. The evaluated nuclear data of the delayed neutron yields of actinide nuclides are still uncertain at the present and the cause of the energy dependence has not been fully understood. In this study, the fission yields of precursor were calculated considering the change of the fission fragment mass yield based on the superposition of fives Gaussian distribution; and the change of the prompt neutrons number associated with the incident energy dependence. Thus, the incident energy dependent behavior of delayed neutron was analyzed.The total number of delayed neutron is expressed as ν{sub d}=∑Y{sub i} • P{sub ni} in the summation method, where Y{sub i} is the mass yields of precursor i and P{sub ni} is the delayed neutron emission probability of precursor i. The value of Y{sub i} is derived from calculation of post neutron emission mass distribution using 5 Gaussian equations with the consideration of large distribution of the fission fragments. The prompt neutron emission ν{sub p} increases at higher incident-energy but there are two different models; one model says that the fission fragment mass dependence that prompt neutron emission increases uniformly regardless of the fission fragments mass; and the other says that the major increases occur at heavy fission fragments area. In this study, the changes of delayed neutron yields by the two models have been investigated.

National critical incident reporting systems relevant to anaesthesia: a European survey.

Science.gov (United States)

Reed, S; Arnal, D; Frank, O; Gomez-Arnau, J I; Hansen, J; Lester, O; Mikkelsen, K L; Rhaiem, T; Rosenberg, P H; St Pierre, M; Schleppers, A; Staender, S; Smith, A F

2014-03-01

Critical incident reporting is a key tool in the promotion of patient safety in anaesthesia. We surveyed representatives of national incident reporting systems in six European countries, inviting information on scope and organization, and intelligence on factors determining success and failure. Some systems are government-run and nationally conceived; others started out as small, specialty-focused initiatives, which have since acquired a national reach. However, both national co-ordination and specialty enthusiasts seem to be necessary for an optimally functioning system. The role of reporting culture, definitional issues, and dissemination is discussed. We make recommendations for others intending to start new systems and speculate on the prospects for sharing patient safety lessons relevant to anaesthesia at European level.

Reducing the incidence of pressure ulcers in critical care units: a 4-year quality improvement.

Science.gov (United States)

Richardson, Annette; Peart, Joanna; Wright, Stephen E; McCullagh, Iain J

2017-06-01

Critical care patients often have several risk factors for pressure ulceration and implementing prevention interventions have been shown to decrease risk. We identified a high incidence of pressure ulcers in the four adult critical care units in our organization. Therefore, avoiding pressure ulceration was an important quality priority. We undertook a quality improvement programme aimed at reducing the incidence of pressure ulceration using an evidence-based bundle approach. A bundle of technical and non-technical interventions were implemented supported by clinical leadership on each unit. Important components were evidence appraisals; changes to mattresses; focussed risk assessment alongside mandating patients at very high risk to be repositioned two hourly; and staff training to increase awareness of how to prevent pressure ulcers. Pressure ulcer numbers, incidence and categories were collected continuously and monitored monthly by unit staff. Pressure ulcer rates reduced significantly from 8.08/100 patient admissions to 2.97/100 patient admissions, an overall relative rate reduction of 63% over 4 years. The greatest reduction was seen in the most severe category of pressure ulceration. The average estimated cost saving was £2.6 million (range £2.1-£3.1). A quality improvement programme including technical and non-technical interventions, data feedback to staff and clinical leadership was associated with a sustained reduction in the incidence of pressure ulceration in the critically ill. Strategies used in this programme may be transferable to other critical care units to bring more widespread patient benefit. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Incident angle dependence of reactions between graphene and hydrogen atom by molecular dynamics simulation

International Nuclear Information System (INIS)

Saito, Seiki; Nakamura, Hiroaki; Ito, Atsushi

2010-01-01

Incident angle dependence of reactions between graphene and hydrogen atoms are obtained qualitatively by classical molecular dynamics simulation under the NVE condition with modified Brenner reactive empirical bond order (REBO) potential. Chemical reaction depends on two parameters, i.e., polar angle θ and azimuthal angle φ of the incident hydrogen. From the simulation results, it is found that the reaction rates strongly depend on polar angle θ. Reflection rate becomes larger with increasing θ, and the θ dependence of adsorption rate is also found. The θ dependence is caused by three dimensional structure of the small potential barrier which covers adsorption sites. φ dependence of penetration rate is also found for large θ. (author)

Brand equity: How is it affected by critical incidents and what moderates the effect

OpenAIRE

Hildebrandt, Lutz; Tischer, Sven

2012-01-01

To explore how occurring critical incidents affect customer-brand relations, this study measures the impact on the basis of an online experiment. For this purpose, 1,122 usable responses are gathered considering the smartphone brands of Apple and Nokia as well as different scenarios. The respective reactions to these negative incidents are evaluated using the concept of customer-based brand equity. More precisely, a structure equation model is specified and differences in latent factor means ...

Effects of proactive and prosocial behavior on critical incidents of Lima schoolchildren

Directory of Open Access Journals (Sweden)

Jhon A. Holguin Alvarez

2017-08-01

Full Text Available The study focuses on the theoretical approaches of proactive and prosocial behavior of Covey (1996, Xifra (2009 and Roche-Olivar (2004, with the objective of analyzing the significant differences in the decrease of critical incidents in public school students And private schools in the district of San Juan de Lurigancho, for which two experimental workshops with quasiexperimental methodology were applied in three groups of 1st and 2nd high school students (G. Exp. (Proactivity = 17; G. Exp. Prosociality = 15; G. Control = 16; A behavior observation log and the PANIC instrument of Monereo and Monte (2011 were used. The results indicate significant differences with better effects in the workshop of proactive behavior (Hrp = 16.59, p <.05; A comparison of the verbal violence dimension in which better effects were obtained by the prosocial behavior workshop (Hrp = 14.12, p <.05; Finally, the limitations were that students in the proactivity workshop slowed down their critical incidents by demonstrating excessive personalism, and for later studies, it is suggested to work the above mentioned workshops, including assaulted students.

Factors influencing patient compliance with therapeutic regimens in chronic heart failure: A critical incident technique analysis.

Science.gov (United States)

Strömberg, A; Broström, A; Dahlström, U; Fridlund, B

1999-01-01

The aim of this study was to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure. A qualitative design with a critical incident technique was used. Incidents were collected through interviews with 25 patients with heart failure strategically selected from a primary health care clinic, a medical ward, and a specialist clinic. Two hundred sixty critical incidents were identified in the interviews and 2 main areas emerged in the analysis: inward factors and outward factors. The inward factors described how compliance was influenced by the personality of the patient, the disease, and the treatment. The outward factors described how compliance was influenced by social activities, social relationships, and health care professionals. By identifying the inward and outward factors influencing patients with chronic heart failure, health care professionals can assess whether intervention is needed to increase compliance.

Mantram repetition for stress management in veterans and employees: a critical incident study.

Science.gov (United States)

Bormann, Jill E; Oman, Doug; Kemppainen, Jeanne K; Becker, Sheryl; Gershwin, Madeline; Kelly, Ann

2006-03-01

This paper reports a study assessing the usefulness of a mantram repetition programme. Complementary/alternative therapies are becoming commonplace, but more research is needed to assess their benefits. A 5-week programme teaching a 'mind-body-spiritual' technique of silently repeating a mantram - a word or phrase with spiritual meaning - to manage stress was developed. A mantram was chosen by individuals, who were taught to repeat it silently throughout the day or night to interrupt unwanted thoughts and elicit the relaxation response. Participants who attended a 5-week course were invited to participate in the study. Of those who consented, a randomly selected subset (n = 66) was contacted approximately 3 months after the course for a telephone interview using the critical incident interviewing technique. Participants were asked whether the intervention was helpful or not, and if helpful, to identify situations where it was applied. Interviews were transcribed and incidents were identified and categorized to create a taxonomy of uses. The data were collected in 2001-2002. Participants included 30 veterans, mostly males (97%), and 36 hospital employees, mostly females (86%). Mean age was 56 years (sd = 12.94). Fifty-five participants (83.3%) practiced the technique and reported 147 incidents where the programme was helpful. Outcomes were organized into a taxonomy of incidents using four major categories that included managing: (a) emotions other than stress (51%); (b) stress (23.8%); (c) insomnia (12.9%); and (d) unwanted thoughts (12.3%). A group of raters reviewed the categories for inter-rater reliability. The majority of participants from two distinct samples reported that the mantram programme was helpful in a variety of situations. The critical incident interviewing method was found to be practical, efficient, and thorough in collecting and analyzing data. Such qualitative methods contribute to understanding the benefits of mind-body complementary therapies.

Using a Critical Incident Scenario With Virtual Humans to Assess Educational Needs of Nurses in a Postanesthesia Care Unit.

Science.gov (United States)

White, Casey; Chuah, Joon; Robb, Andrew; Lok, Benjamin; Lampotang, Samsun; Lizdas, David; Martindale, James; Pi, Guillermo; Wendling, Adam

2015-01-01

During critical incidents, teamwork failures can compromise patient safety. This study provides evidence that virtual humans can be used in simulated critical incidents to assess the learning needs of health professionals, and provide important information that can inform the development of continuing education programs in patient safety. We explored the effectiveness of information transfer during a devolving medical situation between postanesthesia care unit (PACU) nurses and a virtual attending physician. We designed a three-stage scenario: tutorial, patient transfer, and critical incident. We developed 2 checklists to assess information transfer: Critical Patient Information and Interprofessional Communication Skills. All participants were videotaped; 2 raters reviewed all videos and assessed performance using the checklists. Participants (n = 43) who completed all 3 stages scored 62.3% correct on critical patient information transfer and 61.6% correct on interprofessional communication skills. Almost 87% missed a fatal drug error. The checklists measured each item on a 1/0 (done/not) calculation. Additionally, no relationship was found between years of nursing experience and performance on either checklist. The PACU nurses in this study did not consistently share critical information with an attending (virtual) physician during a critical incident, and most missed a fatal dosage error. These findings strongly suggest a crucial need for additional structured team training among practicing health care teams, and they demonstrate the utility of using virtual humans to simulate team members. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis.

Science.gov (United States)

de Boer, Jacoba; Lok, Anja; Van't Verlaat, Ellen; Duivenvoorden, Hugo J; Bakker, Arnold B; Smit, Bert J

2011-07-01

This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals

System Safety Assessment Based on Past Incidents in Oil and Gas Industries: A Focused Approach in Forecasting of Minor, Severe, Critical, and Catastrophic Incidents, 2010–2015

Directory of Open Access Journals (Sweden)

Praveen Patel

2016-01-01

Full Text Available Accident in an occupation which occurred due to series of repetitive minor incidents within the working environment. This work demonstrates the critical system safety assessment based on various incidents that took place to the different system and subsystem of two Indian oil refineries in five years of span 2010 to 2015. The categorization of incidents and hazard rate function of each incident category were classified and calculated. The result of Weibull analysis estimators in the form of scale and shape parameters provides useful information of incidents forecasting and their patterns in a particular time.

Self esteem, dependency, self-efficacy and self-criticism in social anxiety disorder.

Science.gov (United States)

Iancu, Iulian; Bodner, Ehud; Ben-Zion, Itzhak Z

2015-04-01

Social anxiety disorder (SAD) is characterized by fear and avoidance in social situations where one perceives being in danger of scrutiny by others. Low self-esteem, low self-efficacy, high self-criticism and high dependency are additional potential features of SAD, and thus their examination is warranted, as is the elucidation of their inter-relationship. Thirty-two SAD subjects diagnosed with the Mini-International Neuropsychiatric Interview and 30 healthy controls, were administered the Liebowitz Social Anxiety Scale (LSAS), the Rosenberg Self Esteem Scale, the Depressive Experiences Questionnaire (DEQ) that assesses self-criticism, dependency and self-efficacy, and a socio-demographic questionnaire. We hypothesized that the SAD group would present higher scores of dependency and self-criticism and lower self-esteem and self-efficacy. We also hypothesized that low self-esteem, low self-efficacy, high self-criticism and high dependency will predict the severity of SAD. In line with the hypotheses, SAD patients had higher scores of self-criticism and dependency and lower scores of self-esteem. The social anxiety score correlated negatively with self-esteem and self-efficacy, and positively with dependency and self-criticism. Self-criticism, but not the other measures, predicted the total LSAS score. Self-esteem, self-criticism, dependency and self-efficacy are related to SAD and their relations should be examined in future studies that will employ larger samples. It is suggested to search for ways to affect these factors through cognitive-behavioral interventions and additional psychotherapeutic treatments. Research should also focus on the specific role of self-criticism in SAD. Copyright © 2014 Elsevier Inc. All rights reserved.

Factors Associated with the Incidence and Severity of New-Onset Atrial Fibrillation in Adult Critically Ill Patients

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Péricles A. D. Duarte

2017-01-01

Full Text Available Background. Acute Atrial Fibrillation (AF is common in critically ill patients, with significant morbidity and mortality; however, its incidence and severity in Intensive Care Units (ICUs from low-income countries are poorly studied. Additionally, impact of vasoactive drugs on its incidence and severity is still not understood. This study aimed to assess epidemiology and risk factors for acute new-onset AF in critically ill adult patients and the role of vasoactive drugs. Method. Cohort performed in seven general ICUs (including cardiac surgery in three cities in Paraná State (southern Brazil for 45 days. Patients were followed until hospital discharge. Results. Among 430 patients evaluated, the incidence of acute new-onset AF was 11.2%. Patients with AF had higher ICU and hospital mortality. Vasoactive drugs use (norepinephrine and dobutamine was correlated with higher incidence of AF and higher mortality in patients with AF; vasopressin (though used in few patients had no effect on development of AF. Conclusions. In general ICU patients, incidence of new-onset AF was 11.2% with a high impact on morbidity and mortality, particularly associated with the presence of Acute Renal Failure. The use of vasoactive drugs (norepinephrine and dobutamine could lead to a higher incidence of new-onset AF-associated morbidity and mortality.

The Application of Critical Incident Procedures for an Initial Audit of Organizational Communication.

Science.gov (United States)

Rutherford, R. Stanley

This paper discusses the concept of the critical incidents technique, traces its early development in the training of airplane pilots during World War II, sketches the requirements of the typical steps, notes the few studies in communication using this technique, provides an evaluation, and briefly describes a study concerning department chairmen.…

Searching for the QCD Critical Point with the Energy Dependence of pt Fluctuations

Science.gov (United States)

Novak, John; STAR Collaboration

2013-10-01

If systems produced in relativistic heavy-ion collisions pass near the QCD critical point while cooling, the correlation length of the system may diverge due to the phenomena of critical opalescence. The transverse momentum distribution, being related to the state variable temperature, might be sensitive to this change in correlation length. Non-monotonic behavior with changing incident energy or centrality of any transverse momentum observable that is sensitive to the correlation length could thus be indicative of the QCD critical point. Accordingly, we report measurements related to transverse momentum fluctuations such as as a function of event centrality and incident energy for Au+Au collisions at √{sNN} = 7.7, 11.5, 19.6, 27, 39, 62.4, and 200 GeV using the STAR detector at RHIC. The results are compared to UrQMD model predictions and previous experimental measurements.

Dependence on incident angle of solid state detector response to gamma-rays

International Nuclear Information System (INIS)

Yamanishi, Hirokuni; Yamaguchi, Satarou; Yamaguchi, Takayuki; Ueki, Kohtaro

2002-01-01

The shape and size of a NaI(Tl) scintillator that should maximize response variation with γ-ray incident angle was estimated by analytical model calculation. It proved that, even for gamma rays of energy exceeding 1 MeV, a slab detector measuring 50 cm x 50 cm x 5 cm thick should present a ratio of at least 4 between maximum and minimum responses against incidence at different angles. For a sample case of 60 keV gamma rays, estimation of the incident angle dependence by means of Monte Carlo simulation agreed well with experiment using a CZT detector. The counts from photo-electric peak varied with incident angle roughly along a sine curve. The foregoing finding served as basis for proposing a practical direction finder for γ-ray source operating on the principle of determining the source direction from variations in count with incident angle. (author)

[Preliminary results of an anonymous internet-based reporting system for critical incidents in ambulatory primary care].

Science.gov (United States)

Brun, A

2005-03-01

To learn from errors is not always easy, especially if they happened to others! This paper describes the organization and management of a critical incident reporting system for primary care physicians in Switzerland and reports about the difficulties and experiences during the first 18 months since the start of the program. It seems to be particularly difficult to enhance the attentiveness of physicians for apparently harmless daily critical incidents and to motivate them to report it even in an anonymous reporting system. As incentives for more intensive participation there are the hope for comments on reported cases by other participants and the expectation that reported errors will be avoided by the readers.

Neuropathic pain: A personal case reflection on a critical incident

Directory of Open Access Journals (Sweden)

Balaji P Duraisamy

2011-01-01

Full Text Available Neuropathic pain is a distressing symptom for the patient and a difficult symptom for the physician to treat. There is lack of evidence-based clinical guidelines for the management of malignant neuropathic pain. The case reflection is a personal account of what has been learnt from a critical incident in a particular patient in the management of neuropathic pain. Psychological issues are known to increase pain percetion and affect the quality of life. The case reflection explores problem areas, defines lacunae in knowledge, and demonstrates active learning of the management of neuropathic pain through reflective practice.

Travel Behavior Change in Older Travelers: Understanding Critical Reactions to Incidents Encountered in Public Transport

OpenAIRE

Sundling, Catherine

2015-01-01

Accessibility of travel may be better understood if psychological factors underlying change in travel behavior are known. This paper examines older (65+) travelers? motives for changing their travel behavior. These changes are grounded in critical incidents earlier encountered in public-transport travel. A scientific framework is developed based on cognitive and behavioral theory. In 29 individual interviews, travelers? critical reactions (i.e., cognitive, emotional, and/or behavioral) to 77 ...

Early Prediction of Sepsis Incidence in Critically Ill Patients Using Specific Genetic Polymorphisms.

Science.gov (United States)

David, Vlad Laurentiu; Ercisli, Muhammed Furkan; Rogobete, Alexandru Florin; Boia, Eugen S; Horhat, Razvan; Nitu, Razvan; Diaconu, Mircea M; Pirtea, Laurentiu; Ciuca, Ioana; Horhat, Delia; Horhat, Florin George; Licker, Monica; Popovici, Sonia Elena; Tanasescu, Sonia; Tataru, Calin

2017-06-01

Several diagnostic methods for the evaluation and monitoring were used to find out the pro-inflammatory status, as well as incidence of sepsis in critically ill patients. One such recent method is based on investigating the genetic polymorphisms and determining the molecular and genetic links between them, as well as other sepsis-associated pathophysiologies. Identification of genetic polymorphisms in critical patients with sepsis can become a revolutionary method for evaluating and monitoring these patients. Similarly, the complications, as well as the high costs associated with the management of patients with sepsis, can be significantly reduced by early initiation of intensive care.

Recovery from chemical, biological, and radiological incidents. Critical infrastructure and economic impact considerations

Energy Technology Data Exchange (ETDEWEB)

Franco, David Oliver [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Yang, Lynn I. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Hammer, Ann E. [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

2012-06-01

To restore regional lifeline services and economic activity as quickly as possible after a chemical, biological or radiological incident, emergency planners and managers will need to prioritize critical infrastructure across many sectors for restoration. In parallel, state and local governments will need to identify and implement measures to promote reoccupation and economy recovery in the region. This document provides guidance on predisaster planning for two of the National Disaster Recovery Framework Recovery Support Functions: Infrastructure Systems and Economic Recovery. It identifies key considerations for infrastructure restoration, outlines a process for prioritizing critical infrastructure for restoration, and identifies critical considerations for promoting regional economic recovery following a widearea disaster. Its goal is to equip members of the emergency preparedness community to systematically prioritize critical infrastructure for restoration, and to develop effective economic recovery plans in preparation for a widearea CBR disaster.

What's Stalling Learning? Using a Formative Assessment Tool to Address Critical Incidents in Class

Science.gov (United States)

Hessler, H. Brooke; Taggart, Amy Rupiper

2011-01-01

We report on the use of Brookfield's (1995) formative assessment tool, the "Critical Incident Questionnaire" (CIQ) to help students and teachers identify and discuss key factors affecting learning. We offer insight into two major areas: (1) testing and adapting the existing tool to improve teaching and learning; and (2) identifying…

Using the critical incident technique in community-based participatory research: a case study.

Science.gov (United States)

Belkora, Jeffrey; Stupar, Lauren; O'Donnell, Sara

2011-01-01

Successful community-based participatory research involves the community partner in every step of the research process. The primary study for this paper took place in rural, Northern California. Collaborative partners included an academic researcher and two community based resource centers that provide supportive services to people diagnosed with cancer. This paper describes our use of the Critical Incident Technique (CIT) to conduct Community-based Participatory Research. We ask: Did the CIT facilitate or impede the active engagement of the community in all steps of the study process? We identified factors about the Critical Incident Technique that were either barriers or facilitators to involving the community partner in every step of the research process. Facilitators included the CIT's ability to accommodate involvement from a large spectrum of the community, its flexible design, and its personal approach. Barriers to community engagement included training required to conduct interviews, depth of interview probes, and time required. Overall, our academic-community partners felt that our use of the CIT facilitated community involvement in our Community-Based Participatory Research Project, where we used it to formally document the forces promoting and inhibiting successful achievement of community aims.

Developing Flanagan's critical incident technique to elicit indicators of high and low quality nursing care from patients and their nurses.

Science.gov (United States)

Norman, I J; Redfern, S J; Tomalin, D A; Oliver, S

1992-05-01

This paper discusses a development of Flanagan's critical incident technique (CIT) to elicit indicators of high and low quality nursing from patients and their nurses on medical, surgical and elderly care wards. Stages in undertaking the CIT are identified and presuppositions held by most researchers about the nature of the technique are identified. The paper describes how the authors moved to a different set of presuppositions during the course of the study. Preliminary analysis of interview transcripts revealed that critical incidents need not always be demarcated scenes with a clear beginning and end, but may arise from respondents summarizing their overall experience within their description of one incident. Characteristically respondents were unable to give a detailed account of such incidents but validity may be established by the fact that respondents appear to recount what actually happened as they saw it, and what they said was clearly important to them. The researchers found that the most appropriate basic unit of analysis was not the incident itself but 'happenings' revealed by incidents that are 'critical' by virtue of being important to respondents with respect to the quality of nursing care. The importance of CIT researchers achieving an understanding of the 'meaning' of critical happenings to respondents is emphasized. Analysis of the interview transcripts is facilitated by the use of INGRES, a relational database computer program which should enable a 'personal theory' of quality nursing for each respondent, both patients and nurses, to be described. The study suggests that the CIT is a flexible technique which may be adapted to meet the demands of nursing research. If carefully applied, the CIT seems capable of capitalizing on respondents' own stories and avoids the loss of information which occurs when complex narratives are reduced to simple descriptive categories. Patients and nurses have unique perspectives on nursing and their views are of

Intercultural Effectiveness Training in three Western immigrant countries : A cross-cultural evaluation of critical incidents

NARCIS (Netherlands)

Herfst, Selma L.; van Oudenhoven, Jan Pieter; Timmerman, Marieke E.

The purpose of the present study is the evaluation of material for a new intercultural training instrument. More specifically, we examine the validity of 21 critical incidents used in the training. The training programme is targeted at natives in Western immigrant countries dealing - mostly

Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis

NARCIS (Netherlands)

de Boer, Jacoba; Lok, Anja; van 't Verlaat, Ellen; Duivenvoorden, Hugo J.; Bakker, Arnold B.; Smit, Bert J.

2011-01-01

This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively

Deviation from an inverse cosine dependence of kinetic secondary electron emission for angle of incidence at keV energy

International Nuclear Information System (INIS)

Ohya, Kaoru; Kawata, Jun; Mori, Ichiro

1989-01-01

Incident angle dependence of kinetic secondary electron emission from metals resulting from incidence of keV ions is investigated by computer simulation with the TRIM Monte Carlo program of ion scattering in matter. The results show large deviations from the inverse cosine dependence, which derives from high-energy approximation, because of a series of elastic collisions of incident ions with metal atoms. In the keV energy region, the elastic collisions have two different effects on the angular dependence for relatively high-energy light ions and for low-energy heavy ions: they result in over- and under-inverse-cosine dependences, respectively. The properties are observed even with an experiment of the keV-neutral incidence on a contaminated surface. In addition, the effects of the thin oxide layer and roughness on the surface are examined with simplified models. (author)

Analysis of thin films prepared by vacuum-evaporation and dropping solution by Takeoff Angle-Dependent X-Ray Fluorescence spectroscopy at glancing incidence

International Nuclear Information System (INIS)

Tsuji, Kouichi; Hirokawa, Kichinosuke; Mitose, Kengo.

1995-01-01

We have introduced Takeoff Angle-Dependent X-Ray Fluorescence (TAD-XRF) method for thin film and surface analysis. In this method, the sample on the optically flat substrate is irradiated with the glancing incidence of the primary X-ray, and the fluorescent X-rays emitted from the sample are detected at the glancing takeoff angle. We had previously calculated the relationship between the fluorescent X-ray intensity and the takeoff angle at the glancing incidence. The characterization of the thin film is achieved by investigating the dependence of the fluorescent X-ray intensity on the takeoff angle with the calculated curve. Using this analytical method, we have reported the results of the TAD-XRF measured for the evaporated thin films and the dried films from dropping solution in this paper. The effect of the thickness of the thin film, the density of the substrate and the incident angle on the TAD-XRF curve has been reported. In the case of the dried film from the dropping solution, a broad peak was observed at the takeoff angle which was close to the critical angle for the total reflection of the fluorescent X-ray in the TAD-XRF curve. This broad peak was explained by the double-excitation of the incident beam and the refracted beam of the fluorescent X-ray with the assumption that the X-ray which has a same wavelength to the observed fluorescent X-ray impinges upon the sample surface, because the reciprocity theorem is expected in the X-ray region. (author)

A prospective study to select and evaluate anesthesiology residents: phase I, the critical incident technique.

Science.gov (United States)

Altmaier, E M; From, R P; Pearson, K S; Gorbatenko-Roth, K G; Ugolini, K A

1997-12-01

To develop categories of behavior that define an applicant's aptitude for anesthesia, and to attempt to determine the relative importance of these behaviors to successful residency performance. Prospective open study. Anesthesia residencies at three midwest university teaching hospitals. Using a structured interview format known as the critical incident technique, faculty anesthesiologists were asked to describe examples of effective and ineffective behaviors observed among anesthesia residents during the twelve months prior to the interview. Interviews initially held with 34 anesthesiologists generated 172 incidents. These incidents formed the basis for a categorization analysis performed by two anesthesiologists. Six categories were developed: preparedness, interpersonal skills, response to teaching, data monitoring, technical skills, and emergency situations. Validation of these categories was confirmed with three subsequent interviews, in which 92 anesthesiologists generated 475 incidents. Most incidents were found to conform to the previously defined categories using a reallocation index with a range of 0.70 to 0.80. The category "technical skills" fell below the defined range. Over 60 percent of the incidents involved noncognitive personal attributes: preparedness, interpersonal skills, and response to teaching. Effective behavior in six categories identifies an applicant's aptitude for anesthesia. Selection of residents may be enhanced by routinely assessing noncognitive characteristics.

Moments of sorrow and joy : an empirical assessment of the complementary value of critical incidents in understanding customer service evaluations

NARCIS (Netherlands)

Odekerken-Schröder, G.; Birgelen, van M.; Lemmink, J.G.A.M.; Ruyter, de J.C.; Wetzels, M.G.M.

2000-01-01

It is commonly acknowledged that service quality can be measured by using attribute-based and incident-based measurements. Both methods are distinct in nature, but can be used complementarily. However, in the literature a simultaneous empirical investigation of the power of critical incidents in

Energy dependence of critical state of single-component systems

International Nuclear Information System (INIS)

Volchenkova, R.A.

1985-01-01

Equations of critical states of the single-component systems: Psub(cr)(/Psub(o)=(Tsub(cr)/Tsub(o))x0.73, Tsub(cr)=K(Tsub(boil))sup(1.116) and Hsub(cr)(/Hsub(B)=Tsub(sr)/Tsub(B))sup(1.48) where Tsub(B)=1K, Hsub(B)-2 kcal/g-at, K-dimension factor are presented. It is shown that the revealed dependence Hsub(cr)=H(Tsub(cr)) is an energy boundary of a liquid-vapour phase state of the single-component systems beyond limits of which difference between liquid and vapour phases vanishes in increasing the system energy content. The given equations of state are true for all the single-component systems and permit to consider physicomechanical properties of substances in dynamic state depending on external conditions. Critical temperatures and dependences for elements from the most fusible He to infusible W and Re have been calculated

Why general practitioners and consultants change their clinical practice: a critical incident study.

OpenAIRE

Allery, L. A.; Owen, P. A.; Robling, M. R.

1997-01-01

OBJECTIVE: To describe the complete range of factors which doctors recognise as changing their clinical practice and provide a measure of how often education is involved in change. DESIGN: Interviews using the critical incident technique. SETTING: Primary and secondary care. SUBJECTS: Random sample of 50 general practitioners and 50 consultants. MAIN OUTCOME MEASURES: Categories of reasons for change in clinical practice. RESULTS: Doctors described 361 changes in clinical practice, with an av...

[Patient satisfaction in hospital: critical incident technique or standardised questionnaire?].

Science.gov (United States)

Eckhardt-Abdulla, R; Bock, M; Bauer, M

2008-03-01

Questionnaires are usually used for the measurement of patient satisfaction, however, it is increasingly being recognized that the critical incident technique (CIT) also provides valuable insight. Questionnaires of the "Hamburger questionnaire on hospital stay" were distributed to 650 consecutive patients before discharge. Additionally 103 interviews were conducted in which the patients were asked to describe positive and negative incidents during their hospital stay. The results of both methods were then compared. A total of 369 patients returned the questionnaire and 103 patients participated in the interviews. The duration of a single interview was between 5 and 45 min with a mean of 12.7 min+/-10.1 min standard deviation (SD). Cronbach's alpha of the questionnaire was 0.9. A total of 424 incidents were reported, 301 of them were negative compared to 123 positive events. The questionnaires and interviews yielded partly similar and partly different results at category and subcategory levels concerning the areas of weaknesses and strengths in quality performance. The CIT was more concrete but did not give results for all aspects of quality. The CIT, but not the questionnaire, was able to detect 40/56 (71%) of the positive and 33/75 (44%) of the negative reports regarding medical performance and 25/42 (60%) of the positive and 15/51 (29.4%) of the negative reports of the performance of the nurses were revealed by the CIT and not by the questionnaires. The CIT gives valuable insights into the patient's perspective of strengths and weaknesses in hospital care, which might be overlooked by the questionnaire alone. However, the CIT is probably not suited for routine use because it is very time-consuming.

Increased Incidence of Critical Illness in Psoriasis.

Science.gov (United States)

Marrie, Ruth Ann; Bernstein, Charles N; Peschken, Christine A; Hitchon, Carol A; Chen, Hui; Garland, Allan

Psoriasis is associated with an increased risk of comorbid disease. Despite the recognition of increased morbidity in psoriasis, the effects on health care utilisation remain incompletely understood. Little is known about the risk of intensive care unit (ICU) admission in persons with psoriasis. To compare the incidence of ICU admission and post-ICU mortality rates in a psoriasis population compared with a matched population without psoriasis. Using population-based administrative data from Manitoba, Canada, we identified 40 930 prevalent cases of psoriasis and an age-, sex-, and geographically matched cohort from the general population (n = 150 210). We compared the incidence of ICU admission between populations using incidence rates and Cox regression models adjusted for age, sex, socioeconomic status, and comorbidity and compared mortality after ICU admission. Among incident psoriasis cases (n = 30 150), the cumulative 10-year incidence of ICU admission was 5.6% (95% confidence interval [CI], 5.3%-5.8%), 21% higher than in the matched cohort (incidence rate ratio, 1.21; 95% CI, 1.15-1.27). In the prevalent psoriasis cohort, crude mortality in the ICU was 11.5% (95% CI, 9.9%-13.0%), 32% higher than observed in the matched population admitted to the ICU (8.7%; 95% CI, 8.3%-9.1%). Mortality rates after ICU admission remained elevated at all time points in the psoriasis cohort compared with the matched cohort. Psoriasis is associated with an increased risk for ICU admission and with an increased risk of mortality post-ICU admission.

Terrorism in Australia: factors associated with perceived threat and incident-critical behaviours.

Science.gov (United States)

Stevens, Garry; Agho, Kingsley; Taylor, Melanie; Barr, Margo; Raphael, Beverley; Jorm, Louisa

2009-03-27

To help improve incident preparedness this study assessed socio-demographic and socio-economic predictors of perceived risk of terrorism within Australia and willingness to comply with public safety directives during such incidents. The terrorism perception question module was incorporated into the New South Wales Population Health Survey and was completed by a representative sample of 2,081 respondents in early 2007. Responses were weighted against the New South Wales population. Multivariate analyses indicated that those with no formal educational qualifications were significantly more likely (OR = 2.10, 95%CI:1.32-3.35, p terrorism risk perception and concerns regarding potential impacts. The pattern of concern and response among those of migrant background may reflect secondary social impacts associated with heightened community threat, rather than the direct threat of terrorism itself. These findings highlight the need for terrorism risk communication and related strategies to address the specific concerns of these sub-groups as a critical underpinning of population-level preparedness.

Terrorism in Australia: factors associated with perceived threat and incident-critical behaviours

Science.gov (United States)

Stevens, Garry; Agho, Kingsley; Taylor, Melanie; Barr, Margo; Raphael, Beverley; Jorm, Louisa

2009-01-01

Background To help improve incident preparedness this study assessed socio-demographic and socio-economic predictors of perceived risk of terrorism within Australia and willingness to comply with public safety directives during such incidents. Methods The terrorism perception question module was incorporated into the New South Wales Population Health Survey and was completed by a representative sample of 2,081 respondents in early 2007. Responses were weighted against the New South Wales population. Results Multivariate analyses indicated that those with no formal educational qualifications were significantly more likely (OR = 2.10, 95%CI:1.32–3.35, p terrorism risk perception and concerns regarding potential impacts. The pattern of concern and response among those of migrant background may reflect secondary social impacts associated with heightened community threat, rather than the direct threat of terrorism itself. These findings highlight the need for terrorism risk communication and related strategies to address the specific concerns of these sub-groups as a critical underpinning of population-level preparedness. PMID:19323842

Implementation of the critical points model in a SFM-FDTD code working in oblique incidence

Energy Technology Data Exchange (ETDEWEB)

Hamidi, M; Belkhir, A; Lamrous, O [Laboratoire de Physique et Chimie Quantique, Universite Mouloud Mammeri, Tizi-Ouzou (Algeria); Baida, F I, E-mail: omarlamrous@mail.ummto.dz [Departement d' Optique P.M. Duffieux, Institut FEMTO-ST UMR 6174 CNRS Universite de Franche-Comte, 25030 Besancon Cedex (France)

2011-06-22

We describe the implementation of the critical points model in a finite-difference-time-domain code working in oblique incidence and dealing with dispersive media through the split field method. Some tests are presented to validate our code in addition to an application devoted to plasmon resonance of a gold nanoparticles grating.

Auto-Interviewing, Auto-Ethnography and Critical Incident Methodology for Eliciting a Self-Conceptualised Worldview

Directory of Open Access Journals (Sweden)

Béatrice Boufoy-Bastick

2004-01-01

Full Text Available Knowing oneself has been an age-old humanistic concern for many western and oriental philosophers. The same concern is now shared by modern psychologists and anthropologists who seek to understand the "self" and others by eluci­dating their worldviews. This paper presents an auto-anthropological methodology which can ef­fec­tively elucidate one's worldview. This intro­spective qualitative methodology uses integratively three methodological processes, namely auto-inter­viewing, auto-ethnography and critical incident technique to elicit baseline cultural data. The paper reports on how this methodology was used to elicit my current worldview. It first explains how emic data were educed and rendered in emo­tionally enhanced narratives, which were then deconstructed to elicit the major recurring themes in the etic interpretive content analysis. To illus­trate this auto-anthropological methodology, two cultural life events have been used: a critical incident in Singapore and a consciousness raising process in Fiji. The first event revealed my own education ideology while the second made me realise my mitigated support for cultural diversity. URN: urn:nbn:de:0114-fqs0401371

Dependence of critical current on sample length analyzed by the variation of local critical current bent of BSCCO superconducting composite tape

International Nuclear Information System (INIS)

Matsubayashi, H.; Mukai, Y.; Shin, J.K.; Ochiai, S.; Okuda, H.; Osamura, K.; Otto, A.; Malozemoff, A.

2008-01-01

Using the high critical current type BSCCO composite tape fabricated at American Superconductor Corporation, the relation of overall critical current to the distribution of local critical current and the dependence of overall critical current on sample length of the bent samples were studied experimentally and analytically. The measured overall critical current was described well from the distribution of local critical current and n-value of the constituting short elements, by regarding the overall sample to be composed of local series circuits and applying the voltage summation model. Also the dependence of overall critical current on sample length could be reproduced in computer satisfactorily by the proposed simulation method

The importance of critical incident reporting – and how to do it

Directory of Open Access Journals (Sweden)

Tim Fetherston

2015-09-01

Full Text Available If you asked a group of people whether you were more likely to die from an accident when you were in hospital or when you were travelling, either by air or by car, most people would probably say that it was safer to be in hospital. In fact, this couldn’t be further from the truth. If you are a patient, you are a hundred times more likely to die from a critical incident or error in hospital than you are in a transport accident.

Legal decision-making by people with aphasia: critical incidents for speech pathologists.

Science.gov (United States)

Ferguson, Alison; Duffield, Gemma; Worrall, Linda

2010-01-01

The assessment and management of a person with aphasia for whom decision-making capacity is queried represents a highly complex clinical issue. In addition, there are few published guidelines and even fewer published accounts of empirical research to assist. The research presented in this paper aimed to identify the main issues for speech pathologists when decision-making capacity for legal and related matters arose for their clients with aphasia, and to describe qualitatively the nature of these issues and the practices of the speech pathologists in these situations. The methodology was informed by the qualitative research paradigm and made use of the semi-structured interview methods developed for the Critical Incident Technique. Nine speech pathologists, with a range of clinical experience between three and 27 years, were interviewed by telephone, with verbatim notes being taken on-line by the interviewer. The speech pathologists described a total of 21 clients (15 male, six female) with acquired neurological communication disorders (including cerebral vascular accident, traumatic brain injury, and tumour) whose care had raised critical incidents for the speech pathologist in relation to legal and related matters. These verbatim notes were qualitatively analysed using NVivo qualitative analysis software. The main incidents related to legal decisions (for example, power of attorney, will-making), as well as decisions involving consent for medical treatment, discharge, accommodation, and business/financial decisions. In all but one of the incidents recounted, the issues centred on a situation of conflict between the person with aphasia and their family, friends or with the multidisciplinary team. The roles taken by the speech pathologists ranged from those expected within a speech pathology scope of practice, such as that of assessor and consultant, to those which arguably present dilemmas and conflict of interest, for example, interpreter, advocate. The

Suvorexant is associated with a low incidence of delirium in critically ill patients: a retrospective cohort study.

Science.gov (United States)

Masuyama, Tomoyuki; Sanui, Masamitsu; Yoshida, Naoto; Iizuka, Yusuke; Ogi, Kunio; Yagihashi, Satoko; Nagatomo, Kanae; Sasabuchi, Yusuke; Lefor, Alan K

2018-02-08

Benzodiazepine use is a risk factor for the development of delirium in adult intensive care unit (ICU) patients. Suvorexant is an alternative to benzodiazepines to induce sleep, but the incidence of delirium in critically ill patients is unknown. We undertook this retrospective study to investigate the incidence of delirium in patients who receive suvorexant in the ICU. This retrospective cohort study was conducted in a closed 12-bed ICU at a tertiary teaching hospital. Patients admitted to the ICU for 72 h or longer between January and June 2015 were evaluated for delirium using the Confusion Assessment Method for the Intensive Care Unit tool. We evaluated the incidence of delirium in patients who received suvorexant and those who did not. To adjust for confounding factors, multivariable logistic regression analysis was conducted. Study subjects included 118 patients, with a median age of 72 years and a median Acute Physiology and Chronic Health Evaluation II score of 18 points. Eighty-two patients (69.5%) were admitted after cardiovascular surgery. In the suvorexant group, there were fewer post-cardiovascular surgical patients and more medical patients. The duration of mechanical ventilation during ICU stay was longer in the suvorexant group, and sedatives and sleep inducers other than suvorexant were used more frequently in the suvorexant group. The incidence of delirium was 43.8% in the suvorexant group and 58.8% in the non-suvorexant group (P = 0.149). After adjustment for risk factors using multivariable logistic regression analysis, suvorexant was associated with a lower incidence of delirium (odds ratio = 0.23, 95% confidence interval: 0.07-0.73; P = 0.012). Suvorexant was associated with decreased odds of transitioning to delirium in critically ill patients. The use of suvorexant may lower the incidence of delirium in ICU patients. Future prospective studies are warranted. © 2018 Japanese Psychogeriatric Society.

Patients' Perceptions of Nurses' Behaviour That Influence Patient Participation in Nursing Care: A Critical Incident Study

Directory of Open Access Journals (Sweden)

Inga E. Larsson

2011-01-01

Full Text Available Patient participation is an important basis for nursing care and medical treatment and is a legal right in many Western countries. Studies have established that patients consider participation to be both obvious and important, but there are also findings showing the opposite and patients often prefer a passive recipient role. Knowledge of what may influence patients' participation is thus of great importance. The aim was to identify incidents and nurses' behaviours that influence patients' participation in nursing care based on patients' experiences from inpatient somatic care. The Critical Incident Technique (CIT was employed. Interviews were performed with patients (=17, recruited from somatic inpatient care at an internal medical clinic in West Sweden. This study provided a picture of incidents, nurses' behaviours that stimulate or inhibit patients' participation, and patient reactions on nurses' behaviours. Incidents took place during medical ward round, nursing ward round, information session, nursing documentation, drug administration, and meal.

Frozen moments: flashback memories of critical incidents in emergency personnel.

Science.gov (United States)

Kleim, Birgit; Bingisser, Martina-Barbara; Westphal, Maren; Bingisser, Roland

2015-07-01

Emergency Department personnel regularly face highly stressful situations or critical incidents (CIs) that may subsequently be recalled as unbidden intrusive memories. In their most extreme form, such memories are reexperienced as if they were happening again in the present, as flashbacks. This study examined (1) which CIs are associated with flashback memories; (2) candidate person and work-related features that predict flashback memories; and (3) the association between flashback memories and anxiety, depression, and emotional exhaustion. Emergency nurses (N = 91; 80.2% female) were recruited from two urban teaching hospitals and filled in self-report questionnaires. A majority (n = 59, 65%) experienced intrusive memories; almost half of the sample reported that their memories had flashback character. Those involved in resuscitations in the past week were at a fourfold risk for experiencing flashbacks. Having worked more consecutive days without taking time off was associated with a somewhat lower incidence of flashbacks. Moreover, older individuals who reported more work-related conflicts were at greater risk for experiencing flashback memories than their younger colleagues with heightened work conflict and flashback memory scores, respectively. Flashback memories were associated with heightened symptoms of anxiety, depression, and emotional exhaustion. The present findings have implications for evidence-based health promotion in emergency personnel and other individuals regularly exposed to CIs.

The critical incident technique in dental research: A review

Directory of Open Access Journals (Sweden)

Binu Santha

2016-01-01

Full Text Available Research is a scientific quest to find answers to certain questions. It makes us think with curiosity and wonderment about how to make something better. Research contributes in a major way to the development and maintenance of health and health care systems. Qualitative research is concerned with qualitative phenomena and includes subjective assessment of attitudes, opinions, and behavior. It is especially important in the behavioral sciences where the aim is to discover the underlying motives of human behavior. The critical incident technique (CIT is a well-established qualitative research tool used in many areas of health sciences including nursing, medicine, dentistry, and their respective education systems. This technique is described as consisting of “a set of procedures for collecting direct observations of human behavior in such a way as to facilitate their potential usefulness in solving practical problems.” This review gives a gist of CIT and its application in different aspects of dental research.

Terrorism in Australia: factors associated with perceived threat and incident-critical behaviours

Directory of Open Access Journals (Sweden)

Raphael Beverley

2009-03-01

Full Text Available Abstract Background To help improve incident preparedness this study assessed socio-demographic and socio-economic predictors of perceived risk of terrorism within Australia and willingness to comply with public safety directives during such incidents. Methods The terrorism perception question module was incorporated into the New South Wales Population Health Survey and was completed by a representative sample of 2,081 respondents in early 2007. Responses were weighted against the New South Wales population. Results Multivariate analyses indicated that those with no formal educational qualifications were significantly more likely (OR = 2.10, 95%CI:1.32–3.35, p Conclusion Low education level is a risk factor for high terrorism risk perception and concerns regarding potential impacts. The pattern of concern and response among those of migrant background may reflect secondary social impacts associated with heightened community threat, rather than the direct threat of terrorism itself. These findings highlight the need for terrorism risk communication and related strategies to address the specific concerns of these sub-groups as a critical underpinning of population-level preparedness.

Thickness dependence of effective critical exponents in three-dimensional Ising plates

International Nuclear Information System (INIS)

Marques, M.I.; Gonzalo, J.A.

2000-01-01

Phase transitions in ising plates of equal area and different thickness have been studied by the Monte Carlo approach. The evolution of the critical temperature and of the effective critical exponents with the thickness of the lattice has been numerically determined. The thickness dependence of the maximum value of the effective critical exponents is well described by an exponential decay towards the respective three-dimensional value. (author)

The incidence of ocular candidiasis and evaluation of routine opthalmic examination in critically ill patients with candidaemia.

Science.gov (United States)

Gluck, S; Headdon, W G; Tang, Dws; Bastian, I B; Goggin, M J; Deane, A M

2015-11-01

Despite a paucity of data regarding both the incidence of ocular candidiasis and the utility of ophthalmic examination in critically ill patients, routine ophthalmic examination is recommended for critically ill patients with candidaemia. The objectives were to estimate the incidence of ocular candidiasis and evaluate whether ophthalmic examination influenced subsequent management of these patients. We conducted a ten-year retrospective observational study. Data were extracted for all ICU patients who were blood culture positive for fungal infection. Risk factors for candidaemia and eye involvement were quantified and details regarding ophthalmic examination were reviewed. Candida species were cultured in 93 patients. Risk factors for ocular candidiasis were present in 57% of patients. Forty-one percent of patients died prior to ophthalmology examination and 2% of patients were discharged before candidaemia was identified. During examination, signs of ocular candidiasis were only present in one (2.9%) patient, who had a risk factor for ocular candidiasis. Based on these findings, the duration of antifungal treatment for this patient was increased. Ocular candidiasis occurs rarely in critically ill patients with candidaemia, but because treatment regimens may be altered when diagnosed, routine ophthalmic examination is still indicated.

Incidence, prevalence, and mortality of insulin-dependent (type 1) diabetes mellitus in Lithuanian children during 1983-98

DEFF Research Database (Denmark)

Urbonaite, Brone; Zalinkevicius, Rimas; Green, Anders

2002-01-01

AIMS/HYPOTHESIS: Our purpose is to analyze interrelations of the incidence, prevalence and mortality of childhood-onset insulin-dependent diabetes mellitus (type 1) in Lithuania. METHODS: Incidence and prevalence rates were based on the national type 1 diabetes register during 1983-98. The cohort...

Critical current characteristics and history dependence in superconducting SmFeAsOF bulk

International Nuclear Information System (INIS)

Ni, B; Ge, J; Kiuchi, M; Otabe, E S; Gao, Z; Wang, L; Qi, Y; Zhang, X; Ma, Y

2010-01-01

The superconducting SmFeAsO 1-x F x (x=0.2) polycrystalline bulks were prepared by the powder-in-tube (PIT) method. The magnetic field and temperature dependences of critical current densities in the samples were investigated by resistive and ac inductive (Campbell's) methods. It was found that a fairly large shielding current density over 10 9 A/m 2 , which is considered to correspond to the local critical current density, flows locally with the perimeter size similar to the average grain size of the bulk samples, while an extremely low transport current density of about 10 5 A/m 2 corresponding to the global critical current density flows through the whole sample. Furthermore, a unique history dependence of global critical current density was observed, i.e., it shows a smaller value in the increasing-field process than that in the decreasing-field process. The history dependence of global critical current characteristic in our case can be ascribed to the existence of the weak-link property between the grains in SmFeAsO 1-x F x bulk.

Dependence of the solar absorptance of selective absorber coatings on the angle of incidence

Energy Technology Data Exchange (ETDEWEB)

Reed, K A

1977-01-01

The directional solar absorptances ..cap alpha../sub s/(theta) of samples of a number of selective absorber coatings have been determined. The spectral directional hemispherical reflectances plambda(theta;2..pi..) of each sample was measured over the wavelength range 0.3..mu.. to 2.5..mu.. at angles of incidence theta between 10/sup 0/ and 80/sup 0/. The quantity (1-plambda(theta;2..pi..)) was convoluted over an AM2 solar spectrum to obtain ..cap alpha../sub s/(theta) at each angle of incidence. The solar absorptance at near normal incidence varied from sample to sample and from coating to coating, as expected, given the present state of the art. All the absorptances show similar angular dependences, however. When normalized to unity at normal incidence, the data nearly describe a single curve, for which a power series in theta was found. For comparison, the solar absorptance was also determined for freshly prepared lamp black.

Non-monotonic field dependence of critical current in composite superconductors

International Nuclear Information System (INIS)

Andrianov, V.V.; Baev, V.P.; Ivanov, S.S.

1982-01-01

The nonmonotonic field dependence of critical current Im(B/sub a/ in composite superconductors is investigated experimentally for current and field varying simultaneously with final rates I and B/sub a/

Interpersonal problems, dependency, and self-criticism in major depressive disorder.

Science.gov (United States)

Dinger, Ulrike; Barrett, Marna S; Zimmermann, Johannes; Schauenburg, Henning; Wright, Aidan G C; Renner, Fritz; Zilcha-Mano, Sigal; Barber, Jacques P

2015-01-01

The goal of the present research was the examination of overlap between 2 research traditions on interpersonal personality traits in major depression. We hypothesized that Blatt's (2004) dimensions of depressive experiences around the dimensions of relatedness (i.e., dependency) and self-definition (i.e., self-criticism) are associated with specific interpersonal problems according to the interpersonal circumplex model (Leary, 1957). In addition, we examined correlations of interpersonal characteristics with depression severity. Analyses were conducted on 283 patients with major depressive disorder combined from 2 samples. Of the patients, 151 participated in a randomized controlled trial in the United States, and 132 patients were recruited in an inpatient unit in Germany. Patients completed measures of symptomatic distress, interpersonal problems, and depressive experiences. Dependency was associated with more interpersonal problems related to low dominance and high affiliation, while self-criticism was associated with more interpersonal problems related to low affiliation. These associations were independent of depression severity. Self-criticism showed high overlap with cognitive symptoms of depression. The findings support the interpersonal nature of Blatt's dimensions of depressive experiences. Self-criticism is associated with being too distant or cold toward others as well as greater depression severity, but is not related to the dimension of dominance. © 2014 Wiley Periodicals, Inc.

Critical incidents and assistance-seeking behaviors of White mental health practitioners: A transtheoretical framework for understanding multicultural counseling competency.

Science.gov (United States)

Delsignore, Ann Marie; Petrova, Elena; Harper, Amney; Stowe, Angela M; Mu'min, Ameena S; Middleton, Renée A

2010-07-01

An exploratory qualitative analysis of the critical incidents and assistance-seeking behaviors of White mental health psychologists and professional counselors was performed in an effort to examine a theoretical supposition presented within a Person(al)-as-Profession(al) transtheoretical framework (P-A-P). A concurrent nested strategy was used in which both quantitative and qualitative data were collected simultaneously (Creswell, 2003). In this nested strategy, qualitative data was embedded in a predominant (quantitative) method of analysis from an earlier study (see Middleton et al., 2005). Critical incidents categorized as informal (i.e., personal) experiences were cited more often than those characterized as formal (i.e., professional) experiences as influencing the professional perspectives of White mental health practitioners regarding multicultural diversity. Implications for the counseling and psychology professions are discussed.

Dependency and self-criticism in post-partum depression and anxiety: a case control study.

Science.gov (United States)

Vliegen, Nicole; Luyten, Patrick

2009-01-01

This study investigates the role of self-criticism and dependency in inpatient post-partum depressed women (n = 55) and non-depressed controls (n = 37) as well as the relationship between both personality dimensions and severity of depression and anxiety. As expected, mothers with post-partum depression showed not only increased levels of depression but also anxiety compared with non-depressed mothers. Furthermore, they had significantly higher levels of self-criticism, but not of dependency. In the post-partum depressed mothers, both personality dimensions were positively associated with severity of depression. However, in non-depressed mothers, self-criticism was positively associated with depression, while there was an inverse relationship between dependency and severity of depression. In both samples, self-criticism, but not dependency, was related to state anxiety. The cross-sectional nature of this study limits the ability to draw causal conclusions. The study was based on self-report and conducted in relatively small samples.

Time-dependent scattering of incident light of various wavelengths in ferrofluids under external magnetic field

Science.gov (United States)

Jin, Jingyu; Song, Dongxing; Geng, Jiafeng; Jing, Dengwei

2018-02-01

Ferrofluids can exhibit the anisotropic thermodynamic properties under magnetic fields. The dynamic optical properties of ferrofluids in the presence of magnetic fields are of particular interest due to their potential application as various optical devices. Although time-dependent light scattering by ferrofluids have been extensively studied, the effect of wavelength of incident light have been rarely considered. Here, for the first time, we investigated both the time- and wavelength-dependent light scattering in water based ferrofluids containing Fe3O4 nanoparticles under an external magnetic field. The field-induced response behavior of the prepared ferrofluid samples was determined and verified first by thermal conductivity measurement and numerical simulation. Double-beam UV-Vis spectrophotometer was employed to record the temporal evolution of transmitted intensity of incident light of various wavelengths passing through the ferrofluid sample and propagating parallel to the applied field. As expected, the light intensity decreases to a certain value right after the field is turned on due to the thermal fluctuation induced disorder inside the flexible particle chains. Then the light intensity further decreases with time until the appearance of a minimum at time τ0 followed by an inversed increase before finally reaches equilibrium at a particular time. More importantly, the characteristic inversion time τ0 was found to follow a power law increase with the wavelength of incident light (τ0 ∼ λα, where α = 2.07). A quantitative explanation for the wavelength dependence of characteristic time was proposed based on the finite-difference time-domain (FDTD) method. The simulation results are in good agreement with our experimental observations. The time-dependent light scattering in ferrofluids under different incident wavelengths was rationalized by considering both the coarsening process of the particle chains and the occurrence of resonance within the

Incidence, timing and outcome of AKI in critically ill patients varies with the definition used and the addition of urine output criteria

NARCIS (Netherlands)

Koeze, J.; Keus, F.; Dieperink, W.; van der Horst, I. C. C.; Zijlstra, J. G.; van Meurs, M.

2017-01-01

Background: Acute kidney injury (AKI) is a serious complication of critical illness with both attributed morbidity and mortality at short-term and long-term. The incidence of AKI reported in critically ill patients varies substantially with the population evaluated and the definitions used. We aimed

Spherically symmetric random walks. II. Dimensionally dependent critical behavior

International Nuclear Information System (INIS)

Bender, C.M.; Boettcher, S.; Meisinger, P.N.

1996-01-01

A recently developed model of random walks on a D-dimensional hyperspherical lattice, where D is not restricted to integer values, is extended to include the possibility of creating and annihilating random walkers. Steady-state distributions of random walkers are obtained for all dimensions D approx-gt 0 by solving a discrete eigenvalue problem. These distributions exhibit dimensionally dependent critical behavior as a function of the birth rate. This remarkably simple model exhibits a second-order phase transition with a universal, nontrivial critical exponent for all dimensions D approx-gt 0. copyright 1996 The American Physical Society

Using Critical Incidents of Instructional Design and Multimedia Production Activities to Investigate Instructional Designers' Current Practices and Roles

Science.gov (United States)

Sugar, William A.; Luterbach, Kenneth J.

2016-01-01

Through consideration of critical incidents, this study analyzed 106 effective, ineffective and extraordinary instructional design and multimedia production (MP) activities discussed by 36 instructional design professionals. This evaluation provided insights into these professionals' best and not so best practices during the past 6 months.…

Critical Incidents as Formative Influences on the Work of Educational Researchers: Understanding an Insider Perspective through Narrative Enquiry

Science.gov (United States)

Holligan, Chris; Wilson, Michael

2015-01-01

Drawing on insights from phenomenological sociology and various strands of socio-cultural theory, this paper reports the findings of a qualitative investigation into critical incidents as formative influences in the research orientation and research cultivation of 22 academics working in research-intensive university education departments. The…

Magnetic field dependence of the critical superconducting current induced by the proximity effect in silicon

International Nuclear Information System (INIS)

Nishino, T.; Kawabe, U.; Yamada, E.

1986-01-01

The magnetic field dependence of the critical superconducting current induced by the proximity effect in heavily-boron-doped Si is studied experimentally. It is found that the critical current flowing through the p-type-Si-coupled junction decreases with increasing applied magnetic field. The critical current can be expressed as the product of three factors: the current induced by de Gennes's proximity effect, the exponential decrease due to pair breaking by the magnetic field, and the usual diffraction-pattern-like dependence on the magnetic field due to the Josephson effect. The second factor depends on the carrier concentration in the semiconductor. The local critical current shows a rapid decrease at the edge of the electrodes

PERSONALITY PREDISPOSITIONS IN CHINESE ADOLESCENTS: THE RELATION BETWEEN SELF-CRITICISM, DEPENDENCY, AND PROSPECTIVE INTERNALIZING SYMPTOMS

Science.gov (United States)

Cohen, Joseph R.; Young, Jami F.; Hankin, Benjamin L.; Yao, Shuqiao; Zhu, Xiong Zhao; Abela, John R.Z.

2015-01-01

The present study examined the prospective relation between two personality predispositions, self-criticism and dependency, and internalizing symptoms. Specifically, it was examined whether self-criticism and dependency predicted symptoms of depression and social anxiety, and if a moderation (e.g. diathesis-stress) or mediation model best explained the relation between the personality predispositions and emotional distress in Chinese adolescents. Participants included 1,150 adolescents (597 females and 553 males) from mainland China. Participants completed self-report measures of self-criticism, dependency, and neuroticism at baseline, and self-report measures of negative events, depressive symptoms, and social anxiety symptoms once a month for six months. Findings showed that self-criticism predicted depressive symptoms, while dependency predicted social anxiety symptoms. In addition, support was found for a mediation model, as opposed to a moderation model, with achievement stressors mediating the relation between self-criticism and depressive symptoms. Overall, these findings highlight new developmental pathways for the development of depression and social anxiety symptoms in mainland Chinese adolescents. Implications for cross-cultural developmental psychopathology research are discussed. PMID:25798026

Unplanned extubations in an intensive care unit: Findings from a critical incident technique.

Science.gov (United States)

Danielis, Matteo; Chiaruttini, Simona; Palese, Alvisa

2018-05-15

Patients on mechanical ventilation are at risk of experiencing a potentially life-threatening unplanned extubation in the intensive care unit, which can lead to arrhythmias, bronchial aspiration, difficulty in reintubation or even sudden cardiac arrest. Although incidence and outcomes of the phenomenon have been documented in several quantitative studies, no studies have investigated the antecedents as experienced by critical care nurses. To gain a greater understanding of the antecedents of unplanned extubations. A qualitative study design involving the critical-incident technique. A total of 10 registered nurses who reported one or more episodes of unplanned extubations were involved in an in-depth interview. According to the nurses' experience, episodes of unplanned extubations are determined by predisposing, precipitating and mediating factors. The predisposing factors have been recognised in the (a) weaning programme (expected/unexpected decreased sedation) and in the (b) patient factors (increased needs due to discomfort, restlessness and desire to communicate). The precipitating factors have been divided into (a) organisational (failures in multi-professional communication), (b) environmental (excessive environmental chaos and barriers preventing direct surveillance) and (c) nursing care factors (ensuring privacy by creating barriers, avoiding disturbing other patients and poor nurse-to-patient ratio). Among the mediating factors, which are affected by the precipitating factors, decreased surveillance and mechanical restraints' use have been identified. Identifying risk factors of unplanned extubation, specifically those that are modifiable, such as increasing interprofessional communication, reducing excessive environment chaos, implementing strategies aimed at overcoming barriers threatening direct surveillance and ensuring appropriate nurse-to-patient ratio, can prevent the occurrence of these events. Copyright © 2018 Elsevier Ltd. All rights reserved.

Magnetic field and temperature dependence of the critical vortex velocity in type-II superconducting films

Energy Technology Data Exchange (ETDEWEB)

Grimaldi, G; Leo, A; Cirillo, C; Attanasio, C; Nigro, A; Pace, S [CNR-INFM Laboratorio Regionale SuperMat, Via Salvador Allende, I-84081 Baronissi (Italy)], E-mail: grimaldi@sa.infn.it

2009-06-24

We study the vortex dynamics in the instability regime induced by high dissipative states well above the critical current in Nb superconducting strips. The magnetic field and temperature behavior of the critical vortex velocity corresponding to the observed dynamic instability is ascribed to intrinsic non-equilibrium phenomena. The Larkin-Ovchinnikov (LO) theory of electronic instability in high velocity vortex motion has been applied to interpret the temperature dependence of the critical vortex velocity. The magnetic field dependence of the vortex critical velocity shows new features in the low-field regime not predicted by LO.

Perturbative Critical Behavior from Spacetime Dependent Couplings

International Nuclear Information System (INIS)

Torroba, Gonzalo

2012-01-01

We find novel perturbative fixed points by introducing mildly spacetime-dependent couplings into otherwise marginal terms. In four-dimensional QFT, these are physical analogues of the small-ε Wilson-Fisher fixed point. Rather than considering 4-ε dimensions, we stay in four dimensions but introduce couplings whose leading spacetime dependence is of the form λx κ μ κ , with a small parameter κ playing a role analogous to ε. We show, in φ 4 theory and in QED and QCD with massless flavors, that this leads to a critical theory under perturbative control over an exponentially wide window of spacetime positions x. The exact fixed point coupling λ * (x) in our theory is identical to the running coupling of the translationally invariant theory, with the scale replaced by 1/x. Similar statements hold for three-dimensional φ 6 theories and two-dimensional sigma models with curved target spaces. We also describe strongly coupled examples using conformal perturbation theory.

Mate, You Should Know This! Re-Negotiating Practice after a Critical Incident in the Assessment of On-Job Learning

Science.gov (United States)

Vaughan, Karen; Kear, Andrew; MacKenzie, Heath

2014-01-01

This article examines a critical incident during research investigating a new assessment system for on-job learning in carpentry. The system was designed to establish clear relationships between supportive learning environments and purposeful, professional assessment of learners' progress through "naturally occurring evidence" on…

Introduction of a prehospital critical incident monitoring system--pilot project results.

Science.gov (United States)

Stella, Julian; Davis, Anna; Jennings, Paul; Bartley, Bruce

2008-01-01

Hospital medical incident monitoring improves preventable morbidity and mortality rates. Error management systems have been adopted widely in this setting. Data relating to incident monitoring in the prehospital setting is limited. Implementation of an incident monitoring process in a prehospital setting. This is a prospective, descriptive study of the pilot phase of the implementation of an incident monitoring process in a regional prehospital setting, with a focus on trauma care. Paramedics and emergency department staff submitted anonymous incident reports, and a chart review was performed on patients who met major trauma criteria. Selected trauma cases were analyzed by a structured interview/debriefing process to elucidate undocumented incidents. A project committee coded and logged all incidents and developed recommendations. Of 4,429 ambulance responses, 41 cases were analyzed. Twenty-four (58.5%; 95% CI = 49.7-67.4%) were reported anonymously, and the rest were major trauma patients. A total of 77 incidents were identified (mean per case = 1.8; CI = 1.03-2.57). Anonymous cases revealed 26 incidents (mean = 1.1; CI = 0.98-1.22); eight trauma debriefings revealed 38 incidents (mean = 4.8; CI = 0.91-8.69) and nine trauma chart reviews revealed 13 incidents (mean = 1.6; CI = 1.04-2.16). A total of 56 of 77 (72.7%; CI = 65.5-80.0%) incidents related to system inadequacies, and 15 (57.7%; CI = 46.7-68.6%) anonymously reported incidents related to resource problems. A total of 35 of 77 (45.5%; CI = 40.4-50.5%) incidents had minimal or no impact on the patients' outcomes. Thirty-four of 77 (44.2%; CI = 39.3-49.1%) incidents were considered mitigated by circumstance. Incident monitoring led to generalized feedback in most cases (65 of 77; 84.4%; CI = 77.6-91.3%); in three cases (3.9%; CI = 3.7-4.1%), specific education occurred; two cases were reported to an external body (2.6%; CI = 2.5-2.7%); three cases resulted in remedial action (3.9%; CI = 3.7-4.1%); four for

Experience-Dependent Equilibration of AMPAR-Mediated Synaptic Transmission during the Critical Period

Directory of Open Access Journals (Sweden)

Kyung-Seok Han

2017-01-01

Full Text Available Experience-dependent synapse refinement is essential for functional optimization of neural circuits. However, how sensory experience sculpts excitatory synaptic transmission is poorly understood. Here, we show that despite substantial remodeling of synaptic connectivity, AMPAR-mediated synaptic transmission remains at equilibrium during the critical period in the mouse primary visual cortex. The maintenance of this equilibrium requires neurogranin (Ng, a postsynaptic calmodulin-binding protein important for synaptic plasticity. With normal visual experience, loss of Ng decreased AMPAR-positive synapse numbers, prevented AMPAR-silent synapse maturation, and increased spine elimination. Importantly, visual deprivation halted synapse loss caused by loss of Ng, revealing that Ng coordinates experience-dependent AMPAR-silent synapse conversion to AMPAR-active synapses and synapse elimination. Loss of Ng also led to sensitized long-term synaptic depression (LTD and impaired visually guided behavior. Our synaptic interrogation reveals that experience-dependent coordination of AMPAR-silent synapse conversion and synapse elimination hinges upon Ng-dependent mechanisms for constructive synaptic refinement during the critical period.

Vitamin K dependent protein activity and incident ischemic cardiovascular disease: The multi ethnic study of atherosclerosis

Science.gov (United States)

OBJECTIVE: Vitamin K-dependent proteins (VKDPs), which require post-translational modification to achieve biological activity, seem to contribute to thrombus formation, vascular calcification, and vessel stiffness. Whether VKDP activity is prospectively associated with incident cardiovascular diseas...

How do general practice registrars learn from their clinical experience? A critical incident study.

Science.gov (United States)

Holmwood, C

1997-01-01

This preliminary study of RACGP registrars in the period of subsequent general practice experience examines the types of clinical experiences from which registrars learn, what they learn from the experiences and the process of learning from such experiences. A critical incident method was used on a semi structured interview process. Registrars were asked to recall clinical incidents where they had learnt something of importance. Data were sorted and categorised manually. Nine registrars were interviewed before new categories of data ceased to develop. Registrars learnt from the opportunity to follow up patients. An emotional response to the interaction was an important part of the learning process. Learning from such experiences is haphazard and unstructured. Registrars accessed human resources in response to their clinical difficulties rather than text or electronic based information sources. Registrars should be aware of their emotional responses to interactions with patients; these emotional responses often indicate important learning opportunities. Clinical interactions and resultant learning could be made less haphazard by structuring consultations with patients with specific problems. These learning opportunities should be augmented by the promotion of follow up of patients.

Effective classroom teaching methods: a critical incident technique from millennial nursing students' perspective.

Science.gov (United States)

Robb, Meigan

2014-01-11

Engaging nursing students in the classroom environment positively influences their ability to learn and apply course content to clinical practice. Students are motivated to engage in learning if their learning preferences are being met. The methods nurse educators have used with previous students in the classroom may not address the educational needs of Millennials. This manuscript presents the findings of a pilot study that used the Critical Incident Technique. The purpose of this study was to gain insight into the teaching methods that help the Millennial generation of nursing students feel engaged in the learning process. Students' perceptions of effective instructional approaches are presented in three themes. Implications for nurse educators are discussed.

Downtime after Critical Incidents in Emergency Medical Technicians/Paramedics

Directory of Open Access Journals (Sweden)

Janice Halpern

2014-01-01

Full Text Available Effective workplace-based interventions after critical incidents (CIs are needed for emergency medical technicians (EMT/paramedics. The evidence for a period out of service post-CI (downtime is sparse; however it may prevent posttraumatic stress disorder (PTSD and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores. Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between 1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.

Opening up openness: a theoretical sort following critical incidents methodology and a meta-analytic investigation of the trait family measures.

Science.gov (United States)

Connelly, Brian S; Ones, Deniz S; Davies, Stacy E; Birkland, Adib

2014-01-01

Existing taxonomies of Openness's facet structure have produced widely divergent results, and there is limited comprehensive empirical evidence about how Openness-related scales on existing personality inventories align within the 5-factor framework. In Study 1, we used a critical incidents sorting methodology to identify 11 categories of Openness measures; in Study 2, we meta-analyzed the relationships of these categories with global markers of the Big Five traits (utilizing data from 106 samples with a total sample size of N = 35,886). Our results identified 4 true facets of Openness: aestheticism, openness to sensations, nontraditionalism, and introspection. Measures of these facets were unadulterated by variance from other Big Five traits. Many traits frequently conceptualized as facets of Openness (e.g., innovation/creativity, variety-seeking, and tolerance) emerged as trait compounds that, although related to Openness, are also dependent on other Big Five traits. We discuss how Openness should be conceptualized, measured, and studied in light of the empirically based, refined taxonomy emerging from this research.

The incidence and experience of rape among chemically dependent women.

Science.gov (United States)

Teets, J M

1997-01-01

This descriptive study investigated the incidence and experience of rape among chemically dependent women. Sixty women in a residential treatment facility were interviewed about sexual trauma they had experienced in their lives. In this sample 73% had been raped, and 45% had been raped more than once. The stories of rape were classified in five categories: rape while in the context of using, when too high to resist, while prostituting, by a significant other, and by a family member. Some 35% of the rapist described were friends of the women with whom they were using drugs. Only 20% of the rapes were reported to the police. Clinical implications for treatment of addicted women who are also survivors of violence is discussed.

Incidence, prevalence, and mortality of insulin-dependent (type 1) diabetes mellitus in Lithuanian children during 1983-98

DEFF Research Database (Denmark)

Urbonaite, Brone; Zalinkevicius, Rimas; Green, Anders

2002-01-01

-based linear trends of the increase in incidence in various age groups and the annual percentage change for both genders was 2.05 (p = 0.0039) and the greatest regression slope is observed for both genders in the 10-14 yr age group. Regression-based linear trends in type 1 diabetes prevalence indicate an even......AIMS/HYPOTHESIS: Our purpose is to analyze interrelations of the incidence, prevalence and mortality of childhood-onset insulin-dependent diabetes mellitus (type 1) in Lithuania. METHODS: Incidence and prevalence rates were based on the national type 1 diabetes register during 1983-98. The cohort...... study was performed to evaluate the standardized mortality ratios. RESULTS: The average incidence of type 1 diabetes during the 16-yr study period was 7.36 per 100,000/yr. For both males and females the highest incidence of type 1 diabetes was recorded in the 10-14 yr age group. The regression...

Incident-angle dependency found in track formation sensitivity of a plastic nuclear track detector (TD-1)

International Nuclear Information System (INIS)

Yasuda, Hiroshi

1999-01-01

The present study was done since data are hardly available on the incident-angle dependency of track formation sensitivity (S) of the plastic nuclear track detector. Chips of a TD-1 plate, an antioxidant-doped CR-39 (diethyleglycol-bis-allylcarbonate, HARZLAS, Fukuvi Chem. Ind.), were used as a high-LET radiation detector and were exposed to heavy ion beams of C, Ne, and Si under different incident angles in Heavy Ion Medical Accelerator in Chiba of National Institute of Radiological Sciences. After exposed and etched, the chips were observed with an optical microscope and a program for image analysis to calculate S. The S values calculated were found smaller for the beams having lower incident angles. Thus the estimated LET values from the S-LET relationship for vertical incident beams showed large reduction for low-angle particles. Those potential errors should be quantified and corrected in determination of LET spectra in space. (K.H.)

What Helps and Hinders Indigenous Student Success in Higher Education Health Programmes: A Qualitative Study Using the Critical Incident Technique

Science.gov (United States)

Curtis, Elana; Wikaire, Erena; Kool, Bridget; Honey, Michelle; Kelly, Fiona; Poole, Phillippa; Barrow, Mark; Airini; Ewen, Shaun; Reid, Papaarangi

2015-01-01

Tertiary institutions aim to provide high quality teaching and learning that meet the academic needs for an increasingly diverse student body including indigenous students. "Tatou Tatou" is a qualitative research project utilising Kaupapa "Maori" research methodology and the Critical Incident Technique interview method to…

Pediatric critical incidents reported over 15 years at a tertiary care teaching hospital of a developing country.

Science.gov (United States)

Abbasi, Shemila; Khan, Fauzia Anis; Khan, Sobia

2018-01-01

The role of critical incident (CI) reporting is well established in improving patient safety but only a limited number of available reports relate to pediatric incidents. Our aim was to analyze the reported CIs specific to pediatric patients in our database and to reevaluate the value of this program in addressing issues in pediatric anesthesia practice. Incidents related to pediatric population from neonatal period till the age of 12 years were selected. A review of all CI records collected between January 1998 and December 2012, in the Department of Anaesthesiology of Aga Khan University hospital was done. This was retrospective form review. The Department has a structured CI form in use since 1998 which is intermittently evaluated and modified if needed. A total of 451 pediatric CIs were included. Thirty-four percent of the incidents were reported in infants. Ninety-six percent of the reported incidents took place during elective surgery and 4% during emergency surgery. Equipment-related events (n = 114), respiratory events (n = 112), and drug events (n = 110) were equally distributed (25.6%, 25.3%, and 24.7%). Human factors accounted for 74% of reports followed by, equipment failure (10%) and patient factors (8%). Only 5% of the incidents were system errors. Failure to check (equipment/drugs/doses) was the most common cause for human factors. Poor outcome was seen in 7% of cases. Medication and equipment are the clinical areas that need to be looked at more closely. We also recommend quality improvement projects in both these areas as well as training of residents and staff in managing airway-related problems in pediatric patients.

Temperature dependence of critical resolved shear stress for cubic metals

International Nuclear Information System (INIS)

Rashid, H.; Fazal-e-Aleem; Ali, M.

1996-01-01

The experimental measurements for critical resolved shear stress of various BCC and FCC metals have been explained by using Radiation Model. The temperature dependence of CRSS for different cubic metals is found to the first approximation, to upon the type of the crystal. A good agreement between experimental observations and predictions of the Radiation Model is found. (author)

Use of critical incidents to develop a rating form for resident evaluation of faculty teaching.

Science.gov (United States)

Silber, Cynthia; Novielli, Karen; Paskin, David; Brigham, Timothy; Kairys, John; Kane, Gregory; Veloski, Jon

2006-12-01

Monitoring the teaching effectiveness of attending physicians is important to enhancing the quality of graduate medical education. We used a critical incident technique with 35 residents representing a cross-section of programmes in a teaching hospital to develop a 23-item rating form. We obtained ratings of 11 attending physicians in internal medicine and general surgery from 54 residents. We performed linear and logistic regression analysis to relate the items on the form to the residents' overall ratings of the attending physicians and the programme directors' ratings of the attending physicians. The residents rated the attending physicians highly in most areas, but lower in provision of feedback, clarity of written communication and cost-effectiveness in making clinical decisions. When we used the residents' overall ratings as the criterion, the most important aspects of attending physicians' teaching were clarity of written communication, cost-effectiveness, commitment of time and energy and whether the resident would refer a family member or friend to the physician. When we used the programme directors' ratings as the criterion, the additional important aspects of performance were concern for the residents' professional well-being, knowledge of the literature and the delivery of clear verbal and written communication. The critical incident technique can be used to develop an instrument that demonstrates content and construct validity. We found that residents consider commitment of time to teaching and clinical effectiveness to be the most important dimensions of faculty teaching. Other important dimensions include written and verbal communication, cost-effectiveness and concern for residents' professional development.

[Teaching non-technical skills for critical incidents: Crisis resource management training for medical students].

Science.gov (United States)

Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R

2009-06-01

Physicians have to demonstrate non-technical skills, such as communication and team leading skills, while coping with critical incidents. These skills are not taught during medical education. A crisis resource management (CRM) training was established for 4th to 6th year medical students using a full-scale simulator mannikin (Emergency Care Simulator, ECS, METI). The learning objectives of the course were defined according to the key points of Gaba's CRM concept. The training consisted of theoretical and practical parts (3 simulation scenarios with debriefing). Students' self-assessment before and after the training provided the data for evaluation of the training outcome. A total of 65 students took part in the training. The course was well received in terms of overall course quality, debriefings and didactic presentation, the mean overall mark being 1.4 (1: best, 6: worst). After the course students felt significantly more confident when facing incidents in clinical practice. The main learning objectives were achieved. The effectiveness of applying the widely used ECS full-scale simulator in interdisciplinary teaching has been demonstrated. The training exposes students to crisis resource management issues and motivates them to develop non-technical skills.

Patients' experiences and actions when describing pain after surgery--a critical incident technique analysis.

Science.gov (United States)

Eriksson, Kerstin; Wikström, Lotta; Fridlund, Bengt; Årestedt, Kristofer; Broström, Anders

2016-04-01

Postoperative pain assessment remains a significant problem in clinical care despite patients wanting to describe their pain and be treated as unique individuals. Deeper knowledge about variations in patients' experiences and actions could help healthcare professionals to improve pain management and could increase patients' participation in pain assessments. The aim of this study was, through an examination of critical incidents, to describe patients' experiences and actions when needing to describe pain after surgery. An explorative design involving the critical incident technique was used. Patients from one university and three county hospitals in both urban and rural areas were included. To ensure variation of patients a strategic sampling was made according to age, gender, education and surgery. A total of 25 patients who had undergone orthopaedic or general surgery was asked to participate in an interview, of whom three declined. Pain experiences were described according to two main areas: "Patients' resources when in need of pain assessment" and "Ward resources for performing pain assessments". Patients were affected by their expectations and tolerance for pain. Ability to describe pain could be limited by a fear of coming into conflict with healthcare professionals or being perceived as whining. Furthermore, attitudes from healthcare professionals and their lack of adherence to procedures affected patients' ability to describe pain. Two main areas regarding actions emerged: "Patients used active strategies when needing to describe pain" and "Patients used passive strategies when needing to describe pain". Patients informed healthcare professionals about their pain and asked questions in order to make decisions about their pain situation. Selfcare was performed by distraction and avoiding pain or treating pain by themselves, while others were passive and endured pain or refrained from contact with healthcare professionals due to healthcare professionals

Investigation of photon detection probability dependence of SPADnet-I digital photon counter as a function of angle of incidence, wavelength and polarization

Energy Technology Data Exchange (ETDEWEB)

Játékos, Balázs, E-mail: jatekosb@eik.bme.hu; Ujhelyi, Ferenc; Lőrincz, Emőke; Erdei, Gábor

2015-01-01

SPADnet-I is a prototype, fully digital, high spatial and temporal resolution silicon photon counter, based on standard CMOS imaging technology, developed by the SPADnet consortium. Being a novel device, the exact dependence of photon detection probability (PDP) of SPADnet-I was not known as a function of angle of incidence, wavelength and polarization of the incident light. Our targeted application area of this sensor is next generation PET detector modules, where they will be used along with LYSO:Ce scintillators. Hence, we performed an extended investigation of PDP in a wide range of angle of incidence (0° to 80°), concentrating onto a 60 nm broad wavelength interval around the characteristic emission peak (λ=420 nm) of the scintillator. In the case where the sensor was optically coupled to a scintillator, our experiments showed a notable dependence of PDP on angle, polarization and wavelength. The sensor has an average PDP of approximately 30% from 0° to 60° angle of incidence, where it starts to drop rapidly. The PDP turned out not to be polarization dependent below 30°. If the sensor is used without a scintillator (i.e. the light source is in air), the polarization dependence is much less expressed, it begins only from 50°.

Criticality problems in energy dependent neutron transport theory

International Nuclear Information System (INIS)

Victory, H.D. Jr.

1979-01-01

The criticality problem is considered for energy dependent neutron transport in an isotropically scattering, homogeneous slab. Under a positivity assumption on the scattering kernel, an expression can be found relating the thickness of the slab to a parameter characterizing production by fission. This is accomplished by exploiting the Perron-Frobenius-Jentsch characterization of positive operators (i.e. those leaving invariant a normal, reproducing cone in a Banach space). It is pointed out that those techniques work for classes of multigroup problems were the Case singular eigenfunction approach is not as feasible as in the one-group theory, which is also analyzed

Temperature dependence of the interband critical points of bulk Ge and strained Ge on Si

Science.gov (United States)

Fernando, Nalin S.; Nunley, T. Nathan; Ghosh, Ayana; Nelson, Cayla M.; Cooke, Jacqueline A.; Medina, Amber A.; Zollner, Stefan; Xu, Chi; Menendez, Jose; Kouvetakis, John

2017-11-01

Epitaxial Ge layers on a Si substrate experience a tensile biaxial stress due to the difference between the thermal expansion coefficients of the Ge epilayer and the Si substrate, which can be measured using asymmetric X-ray diffraction reciprocal space maps. This stress depends on temperature and affects the band structure, interband critical points, and optical spectra. This manuscripts reports careful measurements of the temperature dependence of the dielectric function and the interband critical point parameters of bulk Ge and Ge epilayers on Si using spectroscopic ellipsometry from 80 to 780 K and from 0.8 to 6.5 eV. The authors find a temperature-dependent redshift of the E1 and E1 + Δ1 critical points in Ge on Si (relative to bulk Ge). This redshift can be described well with a model based on thermal expansion coefficients, continuum elasticity theory, and the deformation potential theory for interband transitions. The interband transitions leading to E0‧ and E2 critical points have lower symmetry and therefore are not affected by the stress.

Nucleation of diindenoperylene and pentacene at thermal and hyperthermal incident kinetic energies

Energy Technology Data Exchange (ETDEWEB)

Kish, Edward R.; Desai, Tushar V.; Greer, Douglas R.; Engstrom, James R., E-mail: jre7@cornell.edu [School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, New York 14853 (United States); Woll, Arthur R. [Cornell High Energy Synchrotron Source, Cornell University, Ithaca, New York 14853 (United States)

2015-05-15

The authors have examined the nucleation of diindenoperylene (DIP) on SiO{sub 2} employing primarily atomic force microscopy and focusing on the effect of incident kinetic energy employing both thermal and supersonic sources. For all incident kinetic energies examined (E{sub i} = 0.09–11.3 eV), the nucleation of DIP is homogeneous and the dependence of the maximum island density on the growth rate is described by a power law. A critical nucleus of approximately two molecules is implicated by our data. A re-examination of the nucleation of pentacene on SiO{sub 2} gives the same major result that the maximum island density is determined by the growth rate, and it is independent of the incident kinetic energy. These observations are readily understood by factoring in the size of the critical nucleus in each case, and the island density, which indicates that diffusive transport of molecules to the growing islands dominate the dynamics of growth in the submonolayer regime.

The unified approach of management and critical incident stress management: helping flight attendants and pilots in the aftermath of September 11.

Science.gov (United States)

McIntosh, Tania

2006-01-01

Experience suggests that effective and appropriate responses of an organization's management after a traumatic incident can help mitigate the reactions of primary, secondary, and tertiary victims. This commentary addresses the managerial response of Southwest Airlines to the trauma induced by September 11. It highlights the effectiveness of the unity between the company, the unions, and the Critical Incident Response Team, as well as the types of interventions that were highly regarded by flight attendants and pilots who received such services. This commentary also defines the phenomenon known as fear of flight.

Auditing organizational communication: evaluating the methodological strengths and weaknesses of the critical incident technique, network analysis, and the communication satisfaction questionnaire

NARCIS (Netherlands)

Koning, K.H.

2016-01-01

This dissertation focuses on the methodology of communication audits. In the context of three Dutch high schools, we evaluated several audit instruments. The first study in this dissertation focuses on the question whether the rationale of the critical incident technique (CIT) still applies when it

Time dependent non-extinction probability for prompt critical systems

International Nuclear Information System (INIS)

Gregson, M. W.; Prinja, A. K.

2009-01-01

The time dependent non-extinction probability equation is presented for slab geometry. Numerical solutions are provided for a nested inner/outer iteration routine where the fission terms (both linear and non-linear) are updated and then held fixed over the inner scattering iteration. Time dependent results are presented highlighting the importance of the injection position and angle. The iteration behavior is also described as the steady state probability of initiation is approached for both small and large time steps. Theoretical analysis of the nested iteration scheme is shown and highlights poor numerical convergence for marginally prompt critical systems. An acceleration scheme for the outer iterations is presented to improve convergence of such systems. Theoretical analysis of the acceleration scheme is also provided and the associated decrease in computational run time addressed. (authors)

Coping with Powerlessness: The Relationship of Gender and Job Dependency to Empowerment-Strategy Usage.

Science.gov (United States)

Mainiero, Lisa A.

1986-01-01

Critical incident interviews of males and females determined coping strategies used during frustrating workplace situations of powerlessness because of dependency on others. Although men and women did not differ in relative job power, women more frequently used an acquiescence strategy. Job dependency, however, determined this strategy more than…

Criticality problems for slabs and spheres in energy dependent neutron transport theory

International Nuclear Information System (INIS)

Victory, H.D. Jr.

1980-01-01

The steady-state equation for energy-dependent neutron transport in isotropically scattering slabs and spheres is formulated as an integral equation. The Perron-Frobenius-Jentzsch theory of positive operators is used to analyze criticality problems for transport in slab and spherical media consisting of core and reflector. In addition, with an adroit selection of diffusion-like solutions, this theory is used to obtain an expression relating the critical radius of a homogeneous sphere to a parameter characterizing fission production. 21 refs

Tensile Strain Dependence of Critical Current for RHQ-Nb3Al Wires

OpenAIRE

Jin, Xinzhe; Oguro, Hidetoshi; Nakamoto, Tatsushi; Awaji, Satoshi; Ogitsu, Toru; Tsuchiya, Kiyosumi; Yamamoto, Akira; Kikuchi, Akihiro; Takeuchi, Takao

2011-01-01

KEK and NIMS have been jointly developing Nb3Al superconducting wire with a rapid heating and quenching (RHQ) method towards high field accelerator magnets in the Large Hadron Collider (LHC) luminosity upgrade. A15-type superconductors such as Nb3Al and Nb3Sn exhibit strain dependence with respect to their critical currents. Therefore, a thorough understanding of strain behavior is necessary for high field accelerator magnet development, which will be critical for the luminosity upgrade of th...

Understanding the Role of Critical Incidents in Relation to Self-Efficacy during Course-Embedded Preservice Teacher Field Experiences: A Qualitative Study

Science.gov (United States)

Epperly, Anna C.

2017-01-01

This qualitative, collective case study documented the development of the self-efficacy beliefs of special education preservice candidates during one semester of a course-embedded field experience in a small, private, faith-based university in the Midwest. Interviews of candidates regarding critical incidents in field experiences as documented by…

Surface Plasmon Polariton Resonance of Gold, Silver, and Copper Studied in the Kretschmann Geometry: Dependence on Wavelength, Angle of Incidence, and Film Thickness

Science.gov (United States)

Takagi, Kentaro; Nair, Selvakumar V.; Watanabe, Ryosuke; Seto, Keisuke; Kobayashi, Takayoshi; Tokunaga, Eiji

2017-12-01

Surface plasmon polariton (SPP) resonance spectra for noble metals (Au, Ag, and Cu) were comprehensively studied in the Kretschmann attenuated total reflection (ATR) geometry, in the wavelength (λ) range from 300 to 1000 nm with the angle of incidence (θ) ranging from 45 to 60° and the film thickness (d) ranging from 41 to 76 nm. The experimental plasmon resonance spectra were reproduced by a calculation that included the broadening effects as follows: (1) the imaginary part of the bulk dielectric constant, (2) the thickness-dependent radiative coupling of the SPP at the metal-air interface to the prism, (3) the lack of conservation of the wavevector parallel to the interface kx(k||) caused by the surface roughness, (4) scanning λ at a fixed θ (changing both energy and kx at the same time) over the SPP dispersion relation. For Au and Ag, the experimental results were in good agreement with the calculated results using the bulk dielectric constants, showing no film thickness dependence of the plasmon resonance energy. A method to extract the true width of the plasmon resonance from raw ATR spectra is proposed and the results are rigorously compared with those expected from the bulk dielectric function given in the literature. For Au and Ag, the width increases with energy, in agreement with that expected from the relaxation of bulk free electrons including the electron-electron interaction, but there is clear evidence of extra broadening, which is more significant for thinner films, possibly due to relaxation pathways intrinsic to plasmons near the interface. For Cu, the visibility of the plasmon resonance critically depends on the evaporation conditions, and low pressures and fast deposition rates are required. Otherwise, scattering from the surface roughness causes considerable broadening of the plasmon resonance, resulting in an apparently fixed resonance energy without clear incident angle dependence. For Cu, the observed plasmon dispersion agrees well with

Quality of nursing care perceived by patients and their nurses: an application of the critical incident technique. Part 2.

Science.gov (United States)

Redfern, S; Norman, I

1999-07-01

The aims of the study were to identify indicators of quality of nursing care from the perceptions of patients and nurses, and to determine the congruence between patients' and nurses' perceptions. The paper is presented in two parts. Part 1 included the background and methods to the study and the findings from the comparison of patients' and nurses' perceptions. Part 2 describes the perceptions of patients and nurses, and draws conclusions drawn from the study as a whole. Patients and nurses in hospital wards were interviewed using the critical incident technique. We grouped 4546 indicators of high and low quality nursing care generated from the interview transcripts into 316 subcategories, 68 categories and 31 themes. The themes were grouped into eight clusters: therapeutic context for care, attitudes and sensitivity, teaching and leadership, motivation to nurse, monitoring and informing, high-dependency care, efficiency and thoroughness, reflection and anticipation. As shown in Part 1 of the paper, congruence between patients' and nurses' perceptions of quality was high and significant, although there was some difference of emphasis. The findings support an emerging theory of interpersonal competence and quality in nursing care.

Critical Steps in Learning From Incidents: Using Learning Potential in the Process From Reporting an Incident to Accident Prevention

NARCIS (Netherlands)

Drupsteen, L.; Groeneweg, J.; Zwetsloot, G.I.J.M.

2013-01-01

Many incidents have occurred because organisations have failed to learn from lessons of the past. This means that there is room for improvement in the way organisations analyse incidents, generate measures to remedy identified weaknesses and prevent reoccurrence: the learning from incidents process.

Incidence of constipation in an intensive care unit

OpenAIRE

Guerra, Tatiana Lopes de Souza; Mendonça, Simone Sotero; Guimarães Marshall, Norma

2013-01-01

Objectives To evaluate the incidence of constipation in critical patients on enteral nutrition in a hospital intensive care unit and to correlate this incidence with the variables found for critical patients. Methods The present investigation was a retrospective analytical study conducted in the intensive care unit of Hospital Regional da Asa Norte (DF) via the analysis of medical records of patients admitted during the period from January to December 2011. Data on the incidence of constipati...

Measuring the Impact of Online Evidence Retrieval Systems using Critical Incidents & Journey Mapping.

Science.gov (United States)

Westbrook, Johanna I; Coiera, Enrico W; Braithwaite, Jeffrey

2005-01-01

Online evidence retrieval systems are one potential tool in supporting evidence-based practice. We have undertaken a program of research to investigate how hospital-based clinicians (doctors, nurses and allied health professionals) use these systems, factors influencing use and their impact on decision-making and health care delivery. A central component of this work has been the development and testing of a broad range of evaluation techniques. This paper provides an overview of the results obtained from three stages of this evaluation and details the results derived from the final stage which sought to test two methods for assessing the integration of an online evidence system and its impact on decision making and patient care. The critical incident and journey mapping techniques were applied. Semi-structured interviews were conducted with 29 clinicians who were experienced users of the online evidence system. Clinicians were asked to described recent instances in which the information obtained using the online evidence system was especially helpful with their work. A grounded approach to data analysis was taken producing three categories of impact. The journey mapping technique was adapted as a method to describe and quantify clinicians' integration of CIAP into their practice and the impact of this on patient care. The analogy of a journey is used to capture the many stages in this integration process, from introduction to the system to full integration into everyday clinical practice with measurable outcomes. Transcribed interview accounts of system use were mapped against the journey stages and scored. Clinicians generated 85 critical incidents and one quarter of these provided specific examples of system use leading to improvements in patient care. The journey mapping technique proved to be a useful method for providing a quantification of the ways and extent to which clincians had integrated system use into practice, and insights into how information

'Oh, no it isn't!' 'Oh, yes it is!'. The omission of criticality incident detection systems in the UK

International Nuclear Information System (INIS)

Thorne, Peter R.; Bowden, Russell L; Venner, Jack

2003-01-01

In the UK, the default position is that every process involving fissile material should have a Criticality Incident Detection and Alarm System (CIDAS), unless a robust argument is made that such a system can be omitted. Implementation has been inconsistent and inefficient. In practice decisions appear to be subjective and there are different views and opinions. This paper argues two opposing points of view and presents some simple ground rules. (author)

Understanding the nature of errors in nursing: using a model to analyse critical incident reports of errors which had resulted in an adverse or potentially adverse event.

Science.gov (United States)

Meurier, C E

2000-07-01

Human errors are common in clinical practice, but they are under-reported. As a result, very little is known of the types, antecedents and consequences of errors in nursing practice. This limits the potential to learn from errors and to make improvement in the quality and safety of nursing care. The aim of this study was to use an Organizational Accident Model to analyse critical incidents of errors in nursing. Twenty registered nurses were invited to produce a critical incident report of an error (which had led to an adverse event or potentially could have led to an adverse event) they had made in their professional practice and to write down their responses to the error using a structured format. Using Reason's Organizational Accident Model, supplemental information was then collected from five of the participants by means of an individual in-depth interview to explore further issues relating to the incidents they had reported. The detailed analysis of one of the incidents is discussed in this paper, demonstrating the effectiveness of this approach in providing insight into the chain of events which may lead to an adverse event. The case study approach using critical incidents of clinical errors was shown to provide relevant information regarding the interaction of organizational factors, local circumstances and active failures (errors) in producing an adverse or potentially adverse event. It is suggested that more use should be made of this approach to understand how errors are made in practice and to take appropriate preventative measures.

Determination, through of thermoluminescence dosimetry, of the incident radiation in critical organs, during cephalometric radiographies

International Nuclear Information System (INIS)

Hipolito Junior, O. di; Goncalves, N.; Boscolo, F.N.; Montebelo Filho, A.

1985-01-01

The object of this paper was to value and to compare the doses of X-ray incident in critical orgas of patient and operator, during cephalometric radiography. Each patient was submited for two radiographics expositions. First of all, they use the followings factors: 85 kVp, 15 mA and 4/10 s of exposition; while of the second radiography the conditions were of 70 kVp, 15 mA and 1.2 s of exposition. The dosimetric method was the thermoluminescent through the LiF-700. Although the cephalometric radiographies showed similars qualities, in bot conditions where the equipment functioned, the situation of high voltage was noted small doses of radiation. (author) [pt

Incidence of iatrogenic opioid dependence or abuse in patients with pain who were exposed to opioid analgesic therapy: a systematic review and meta-analysis.

Science.gov (United States)

Higgins, C; Smith, B H; Matthews, K

2018-06-01

The prevalence and incidence of chronic conditions, such as pain and opioid dependence, have implications for policy development, resource allocation, and healthcare delivery. The primary objective of the current review was to estimate the incidence of iatrogenic opioid dependence or abuse after treatment with opioid analgesics. Systematic electronic searches utilised six research databases (Embase, Medline, PubMed, Cinahl Plus, Web of Science, OpenGrey). A 'grey' literature search and a reference search of included articles were also undertaken. The PICOS framework was used to develop search strategies and the findings are reported in accordance with the PRISMA Statement. After eligibility reviews of 6164 articles, 12 studies (involving 310 408 participants) were retained for inclusion in the meta-analyses. A random effects model (DerSimonian-Laird method) generated a pooled incidence of opioid dependence or abuse of 4.7%. There was little within-study risk of bias and no significant publication bias; however, substantial heterogeneity was found among study effects (99.78%). Sensitivity analyses indicated that the diagnostic criteria selected for identifying opioid dependence or abuse (Diagnostic Statistical Manual (DSM-IV) vs International Classification of Diseases (ICD-9)) accounted for 20% and duration of exposure to opioid analgesics accounted for 18% of variance in study effects. Longer-term opioid analgesic exposure, and prescription of strong rather than weak opioids, were associated with a significantly lower incidence of opioid dependence or abuse. The incidence of iatrogenic opioid dependence or abuse was 4.7% of those prescribed opioids for pain. Further research is required to confirm the potential for our findings to inform prevention of this serious adverse event. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Magnetic field dependence of the critical current density in YBa2Cu3Ox ceramics

International Nuclear Information System (INIS)

Zhukov, A.A.; Moshchalkov, V.V.; Komarkov, D.A.; Shabatin, V.P.; Gordeev, S.N.; Shelomov, D.V.

1989-01-01

Three magnetic field ranges corresponding to different critical current density j c behavior have been found out. They correlate with grain magnetization changes. The inverse critical current density is shown to depend linearly on the sample cross-section due to the magnetic field induced by the flowing current

Grain size dependence of the critical current density in YBa2Cu3Ox superconductors

International Nuclear Information System (INIS)

Kuwabara, M.; Shimooka, H.

1989-01-01

The grain size dependence of the critical current density in bulk single-phase YBa 2 Cu 3 O x ceramics was investigated. The grain size of the materials was changed to range approximately from 1.0 to 25 μm by changing the conditions of power processing and sintering, associated with an increase in the sintered density of the materials with increasing grain size. The critical current density has been found to exhibit a significant grain size dependence, changing from 880 A/cm 2 to a value of 100 A/cm 2 with a small increase in the average grain size from 1.2 to 2.0 μm. This seems to provide information about the nature of the weak link between superconducting grains which might govern the critical current density of the materials

Effect of surface roughness on takeoff-angle-dependent X-ray fluorescence of ultrathin films at glancing incidence

International Nuclear Information System (INIS)

Tsuji, Kouichi; Hirokawa, Kichinosuke; Sasaki, Atsushi.

1994-01-01

We had previously shown that takeoff-angle-dependent X-ray fluorescence (TAD-XRF) at glancing incidence is a useful method for the characterization of thin films. Here we report the effect of surface roughness of the substrate on TAD-XRF of an ultrathin film at a glancing incidence. An optically flat glass, scratched glasses and plano-convex lenses were used as substrates. A large-range contour such as warp and a roughness of microscopic scale affect the TAD-XRF profile. Therefore, to characterize the ultrathin film by the TAD-XRF method, the material whose roughness is being investigated should be used as the substrate in TAD-XRF measurement. (author)

Early hybrid approach and enteral feeding algorithm could reduce the incidence of necrotising enterocolitis in neonates with ductus-dependent systemic circulation.

Science.gov (United States)

Manuri, Lucia; Morelli, Stefano; Agati, Salvatore; Saitta, Michele B; Oreto, Lilia; Mandraffino, Giuseppe; Iannace, Enrico; Iorio, Fiore S; Guccione, Paolo

2017-01-01

The reported incidence of necrotising enterocolitis in neonates with complex CHD with ductus-dependent systemic circulation ranges from 6.8 to 13% despite surgical treatment; the overall mortality is between 25 and 97%. The incidence of gastrointestinal complications after hybrid palliation for neonates with ductus-dependent systemic circulation still has to be defined, but seems comparable with that following the Norwood procedure. We reviewed the incidence of gastrointestinal complications in a series of 42 consecutive neonates with ductus-dependent systemic circulation, who received early hybrid palliation associated with a standardised feeding protocol. The median age and birth weight at the time of surgery were 3 days (with a range from 1 to 10 days) and 3.07 kg (with a range from 1.5 to 4.5 kg), respectively. The median ICU length of stay was 7 days (1-70 days), and the median hospital length of stay was 16 days (6-70 days). The median duration of mechanical ventilation was 3 days. Hospital mortality was 16% (7/42). In the postoperative period, 26% of patients were subjected to early extubation, and all of them received treatment with systemic vasodilatory agents. Feeding was started 6 hours after extubation according to a dedicated feeding protocol. After treatment, none of our patients experienced any grade of necrotising enterocolitis or major gastrointestinal adverse events. Our experience indicates that the combination of an "early hybrid approach", systemic vasodilator therapy, and dedicated feeding protocol adherence could reduce the incidence of gastrointestinal complications in this group of neonates. Fast weaning from ventilatory support, which represents a part of our treatment strategy, could be associated with low incidence of necrotising enterocolitis.

A Sequential Mixed Methods Study: An Exploration of the Use of Emotional Intelligence by Senior Student Affairs Officers in Managing Critical Incidents

Science.gov (United States)

Johnson, Brian

2013-01-01

Emotional intelligence is a relatively new academic discipline that began forming in the early 1990s. Currently, emotional intelligence is used in academia and in business as a new intelligence quotient. This research study investigates how Senior Student Affairs Officers' use their emotional intelligence ability during critical incidents. The…

Analysis of Design and Delivery of Critical Incident Workshops for Elementary School English as a Foreign Language Teachers in Community of Practice

Science.gov (United States)

Chien, Chin-Wen

2018-01-01

Language teachers can uncover new understanding of the teaching and learning process through reflecting on critical incidents [Richard, J.C., and T.S.C. Farrell. 2005. "Professional Development for Language Teachers." New York, NY: Cambridge University Press]. Based on the data analysis of workshop handouts, observation notes, and…

Bifurcation analysis of a discrete SIS model with bilinear incidence depending on new infection.

Science.gov (United States)

Cao, Hui; Zhou, Yicang; Ma, Zhien

2013-01-01

A discrete SIS epidemic model with the bilinear incidence depending on the new infection is formulated and studied. The condition for the global stability of the disease free equilibrium is obtained. The existence of the endemic equilibrium and its stability are investigated. More attention is paid to the existence of the saddle-node bifurcation, the flip bifurcation, and the Hopf bifurcation. Sufficient conditions for those bifurcations have been obtained. Numerical simulations are conducted to demonstrate our theoretical results and the complexity of the model.

Dependence of ion-electron emission from clean metals on the incidence angle of the projectile

International Nuclear Information System (INIS)

Ferron, J.; Alonso, E.V.; Baragiola, R.A.; Oliva-Florio, A.

1981-01-01

We have studied the dependence of electron yields γ from clean Cu and Au surfaces on the incidence angle theta of 5--50-keV He + , Ar + , and Xe + projectiles, in the angular range 0--80 0 , and under ultrahigh-vacuum conditions. We have found that, at small angles, γproportionalsec/sup f/theta, with f generally different from unity. For Xe + on Cu, γ(theta) presents an energy-dependence maximum, similar to that obtained for sputtering. The results are explained in terms of the anisotropy of the electron cascade in the solid, the depth distribution of the inelastic energy deposited by the projectile and by rapidly recoiling target atoms in the near-surface region of the solid

Critical Counseling Behavior in Rehabilitation Settings.

Science.gov (United States)

Jaques, Marceline E.

This study investigates rehabilitation counseling to determine critical job requirements, training needs, and differences in counselor perception of critical incidents as a function of academic preparation. A questionnaire requesting one effective and one ineffective counseling incident was distributed to 404 counselors and supervisors from…

Critical Incidents Typically Emerging during the Post-Formation Phase of a New Venture: Perspectives for Entrepreneurship Education and Start-up Counselling

Science.gov (United States)

Heinrichs, Karin; Jäcklin, Benjamin

2017-01-01

During the post-formation phase, young ventures are often in danger of sliding into bankruptcy. The entrepreneur has to deal with a multitude of complex problems, decisions have to be made under time pressure or uncertainty, and upcoming crises have to be perceived in time. This paper presents seven critical incidents that are (1) realistic,…

Computers in radiology. The sedation, analgesia, and contrast media computerized simulator: a new approach to train and evaluate radiologists' responses to critical incidents

International Nuclear Information System (INIS)

Medina, L.S.; Racadio, J.M.; Schwid, H.A.

2000-01-01

Background. Awareness and preparedness to handle sedation, analgesia, and contrast-media complications are key in the daily radiology practice. Objective. The purpose is to create a computerized simulator (PC-Windows-based) that uses a graphical interface to reproduce critical incidents in pediatric and adult patients undergoing a wide spectrum of radiologic sedation, analgesia and contrast media complications. Materials and methods. The computerized simulator has a comprehensive set of physiologic and pharmacologic models that predict patient response to management of sedation, analgesia, and contrast-media complications. Photorealistic images, real-time monitors, and mouse-driven information demonstrate in a virtual-reality fashion the behavior of the patient in crisis. Results. Thirteen pediatric and adult radiology scenarios are illustrated encompassing areas such as pediatric radiology, neuroradiology, interventional radiology, and body imaging. The multiple case scenarios evaluate randomly the diagnostic and management performance of the radiologist in critical incidents such as oversedation, anaphylaxis, aspiration, airway obstruction, apnea, agitation, bronchospasm, hypotension, hypertension, cardiac arrest, bradycardia, tachycardia, and myocardial ischemia. The user must control the airway, breathing and circulation, and administer medications in a timely manner to save the simulated patient. On-line help is available in the program to suggest diagnostic and treatment steps to save the patient, and provide information about the medications. A printout of the case management can be obtained for evaluation or educational purposes. Conclusion. The interactive computerized simulator is a new approach to train and evaluate radiologists' responses to critical incidents encountered during radiologic sedation, analgesia, and contrast-media administration. (orig.)

Safety and Health Standard 110: Incident/accident reporting and investigation

Energy Technology Data Exchange (ETDEWEB)

Sones, K. [West Kootenay Power, BC (Canada)

1999-10-01

Incident/accident reporting requirements in effect at West Kootenay Power are discussed. Details provided include definitions of low risk, high risk, and critical events, the incidents to be reported, the nature of the reports, the timelines, the investigation to be undertaken for each type of incident/accident, counselling services available to employees involved in serious incidents, and the procedures to be followed in accidents involving serious injury to non-employees. The emphasis is on the `critical five` high risk events and the procedures relating to them.

Students' perceptions of effective learning experiences in dental school: a qualitative study using a critical incident technique.

Science.gov (United States)

Victoroff, Kristin Zakariasen; Hogan, Sarah

2006-02-01

Students' views of their educational experience can be an important source of information for curriculum assessment. Although quantitative methods, particularly surveys, are frequently used to gather such data, fewer studies have employed qualitative methods to examine students' dental education experiences. The purpose of this study is to explore characteristics of effective learning experiences in dental school using a qualitative method. All third-year (seventy) and fourth-year (seventy) dental students enrolled in one midwestern dental school were invited to participate. Fifty-three dental students (thirty-five male and eighteen female; thirty-two third-year and twenty-one fourth-year) were interviewed using a critical incident interview technique. Each student was asked to describe a specific, particularly effective learning incident that he or she had experienced in dental school and a specific, particularly ineffective learning incident, for comparison. Each interview was audiotaped. Students were assured that only the interviewer and one additional researcher would have access to the tapes. Data analysis resulted in identification of key themes in the data describing characteristics of effective learning experiences. The following characteristics of effective learning experiences were identified: 1) instructor characteristics (personal qualities, "checking-in" with students, and an interactive style); 2) characteristics of the learning process (focus on the "big picture," modeling and demonstrations, opportunities to apply new knowledge, high-quality feedback, focus, specificity and relevance, and peer interactions); and 3) learning environment (culture of the learning environment, technology). Common themes emerged across a wide variety of learning incidents. Although additional research is needed, the characteristics of effective learning experiences identified in this study may have implications for individual course design and for the dental school

Ion mass dependence for low energy channeling in single-wall nanotubes

International Nuclear Information System (INIS)

Zheng Liping; Zhu Zhiyuan; Li Yong; Zhu Dezhang; Xia Huihao

2008-01-01

An Monte Carlo (MC) simulation program has been used to study ion mass dependence for the low energy channeling of natural- and pseudo-Ar ions in single-wall nanotubes. The MC simulations show that the channeling critical angle Ψ C obeys the (E) -1/2 and the (M 1 ) -1/2 rules, where E is the incident energy and M 1 is the ion mass. The reason for this may be that the motion of the channeled (or de-channeled) ions should be correlated with both the incident energy E and the incident momentum (2M 1 E) 1/2 , in order to obey the conservation of energy and momentum

Dependence of ion-electron emission from clean metals on the incidence angle of the projectile

Energy Technology Data Exchange (ETDEWEB)

Ferron, J.; Alonso, E.V.; Baragiola, R.A.; Oliva-Florio, A.

1981-10-15

We have studied the dependence of electron yields ..gamma.. from clean Cu and Au surfaces on the incidence angle theta of 5--50-keV He/sup +/, Ar/sup +/, and Xe/sup +/ projectiles, in the angular range 0--80 /sup 0/, and under ultrahigh-vacuum conditions. We have found that, at small angles, ..gamma..proportionalsec/sup f/theta, with f generally different from unity. For Xe/sup +/ on Cu, ..gamma..(theta) presents an energy-dependence maximum, similar to that obtained for sputtering. The results are explained in terms of the anisotropy of the electron cascade in the solid, the depth distribution of the inelastic energy deposited by the projectile and by rapidly recoiling target atoms in the near-surface region of the solid.

The mediating role of self-criticism and dependency in the association between perceptions of maternal caring and depressive symptoms.

Science.gov (United States)

Campos, Rui C; Besser, Avi; Blatt, Sidney J

2010-12-01

This study examined a theoretically based mediation model including participants' perceptions of early relationships with their mother, self-criticism, dependency, and current depressive symptoms. We expect that (a) early relationships characterized by low levels of care and high levels of overprotection will be positively associated with both current depressive state and self-criticism and dependency; (b) high levels of self-criticism and dependency will be positively associated with depressive symptoms; and (c) self-criticism and dependency will play a mediating role in the association between participants' perceptions of early relationships characterized by low levels of care and high levels of overprotection and their current depressive symptoms. A nonclinical community sample of 200 Portuguese adults participated in the study. Perceptions of early relationships were measured using the mother scales of the Parental Bonding Instrument (Parker et al. [1979: Br J Med Psychol 52:1-10]), levels of self-criticism and dependency were measured using the Depressive Experiences Questionnaire (Blatt et al. [1976: J Abn Psy 6:383-389]), and depressive symptoms were measured using the Center for the Epidemiological Studies of Depression Scale (Radloff [1977: Appl Psychol Meas 1:385-401]. Structural equation modeling showed that the link between participants' perceptions of early caretaking relationships with their mothers and their current depressive symptoms is mediated by high levels of self-criticism--a personality trait associated with vulnerability to depression--but not Dependency. However, an ancillary analysis indicated that the link between participants' perceptions of early maternal overprotective relationships and their current depressive symptoms is mediated by high levels of Neediness. Findings underscore the role of perceived early relationships in psychological vulnerability to depression among highly self-critical and among highly needy individuals and

Critical analysis of major incidents risks in civil nuclear energy

International Nuclear Information System (INIS)

2000-09-01

The differences existing between the PWR type reactors and the RBMK type reactors are explained as well as the risk associated to each type when it exists. The Ines scale, tool to give the level of an accident gravity comprises seven levels, the number seven is the most serious and corresponds to the Chernobyl accident; The number zero is of no consequence but must be mentioned as a matter of form. The incidents from 1 to 3 concern increasing incidents, affecting the nuclear power plant but not the external public. The accidents from 4 to 7 have a nature to affect the nuclear power plant and the environment. An efficient tool exists between nuclear operators it is made of the reports on incidents encountered by close reactors. Two others type reactors are coming, the high temperature type reactors and the fast neutrons reactors. different risks are evoked, terrorism, proliferation, transport and radioactive wastes. (N.C.)

Dependence of critical current density on crystalline direction in thin YBCO films

DEFF Research Database (Denmark)

Paturi, P.; Peurla, M.; Raittila, J.

2005-01-01

The dependence of critical current density (J(c)) on the angle between the current direction and the (100) direction in the ab-plane of thin YBCO films deposited on (001)-SrTiO3 from natiocrystalline and microcrystalline targets is studied using magneto-optical microscopy. In the films made from...... the nanocrystalline target it is found that J(c) does not depend on the angle whereas J(c) decreases with increasing angle in the films made from the microcrystalline target. The films were characterized by detailed X-ray diffraction measurements. The findings are explained in terms of a network of planar defects...

Temperature dependence of the upper critical field of type II superconductors with fluctuation effects

International Nuclear Information System (INIS)

Mikitik, G.P.

1992-01-01

Fluctuations of the order parameter are taken into consideration in an analysis of the temperature dependence of the upper critical field of a type II superconductor with a three-dimensional superconductivity. This temperature dependence is of universal applicability, to all type II superconductors, if the magnetic fields and temperatures are expressed in appropriate units. This dependence is derived explicitly for the regions of strong and weak magnetic fields. The results are applied to high T c superconductors, for which fluctuation effects are important. For these superconductors, the H c2 (T) dependence is quite different from the linear dependence characteristic of the mean-field theory, over a broad range of magnetic fields

Critical steps in learning from incidents: using learning potential in the process from reporting an incident to accident prevention.

Science.gov (United States)

Drupsteen, Linda; Groeneweg, Jop; Zwetsloot, Gerard I J M

2013-01-01

Many incidents have occurred because organisations have failed to learn from lessons of the past. This means that there is room for improvement in the way organisations analyse incidents, generate measures to remedy identified weaknesses and prevent reoccurrence: the learning from incidents process. To improve that process, it is necessary to gain insight into the steps of this process and to identify factors that hinder learning (bottlenecks). This paper presents a model that enables organisations to analyse the steps in a learning from incidents process and to identify the bottlenecks. The study describes how this model is used in a survey and in 3 exploratory case studies in The Netherlands. The results show that there is limited use of learning potential, especially in the evaluation stage. To improve learning, an approach that considers all steps is necessary.

Working relationships between obstetric care staff and their managers: a critical incident analysis.

Science.gov (United States)

Chipeta, Effie; Bradley, Susan; Chimwaza-Manda, Wanangwa; McAuliffe, Eilish

2016-08-26

Malawi continues to experience critical shortages of key health technical cadres that can adequately respond to Malawi's disease burden. Difficult working conditions contribute to low morale and frustration among health care workers. We aimed to understand how obstetric care staff perceive their working relationships with managers. A qualitative exploratory study was conducted in health facilities in Malawi between October and December 2008. Critical Incident Analysis interviews were done in government district hospitals, faith-based health facilities, and a sample of health centres' providing emergency obstetric care. A total of 84 service providers were interviewed. Data were analyzed using NVivo 8 software. Poor leadership styles affected working relationships between obstetric care staff and their managers. Main concerns were managers' lack of support for staff welfare and staff performance, lack of mentorship for new staff and junior colleagues, as well as inadequate supportive supervision. All this led to frustrations, diminished motivation, lack of interest in their job and withdrawal from work, including staff seriously considering leaving their post. Positive working relationships between obstetric care staff and their managers are essential for promoting staff motivation and positive work performance. However, this study revealed that staff were demotivated and undermined by transactional leadership styles and behavior, evidenced by management by exception and lack of feedback or recognition. A shift to transformational leadership in nurse-manager relationships is essential to establish good working relationships with staff. Improved providers' job satisfaction and staff retentionare crucial to the provision of high quality care and will also ensure efficiency in health care delivery in Malawi.

Incidence and risk factors of acute kidney injury among the critically ill neonates

Directory of Open Access Journals (Sweden)

Ayman A El-Badawy

2015-01-01

Full Text Available Acute kidney injury (AKI is a complex disorder with clinical manifestations ranging from mild dysfunction to complete kidney failure. The published literature on the incidence and outcome of AKI in the critically ill neonatal population is scarce. The aim of this study was to evaluate the types, the associated risk factors and short-term outcome of AKI in the critically ill neonates. A cohort study was conducted including 100 critically ill neonates successively admitted to the Neonatal Intensive Care Unit. The inclusion criteria were a gestational age ≥28 weeks and body weight ≥1 kg. Exclusion criteria included those with multiple congenital anomalies or on drugs altering glomerular filtration rate or AKI developing postoperatively. Neonates were evaluated for the development of AKI [creatinine >1.5 mg/dL and/or blood urea nitrogen (BUN >20 mg/dL] and were assigned as group A (who developed AKI and group B (who did not develop AKI. Forty-one patients developed AKI (group A among whom nine (22% showed oliguric AKI. The most common risk factors among group A patients were sepsis (75.6% and nephrotoxic drug administration (75.6%, followed by shock (39%. There were no statistically significant differences between both groups except for male sex predominance and necrotizing enterocolitis (NEC, which were significantly higher among group A (P <0.05. Use of continuous positive airway pressure (CPAP ventilation was significantly higher in neonates without AKI (13.6% vs 0.0%, P = 0.02. The mortality rate among group A reached 51.2%. Various risk factors including gender, gestational age, birth weight, shock, NEC, sepsis, nephrotoxic drugs, oliguria and mechanical ventilation were studied as regards outcome of group A, and all factors except gender and oliguria proved to be significantly higher in deceased neonates. Male sex and NEC were important risk factors for developing AKI that was predominantly non-oliguric. CPAP ventilation may have a

Nanoparticle separation based on size-dependent aggregation of nanoparticles due to the critical Casimir effect.

Science.gov (United States)

Guo, Hongyu; Stan, Gheorghe; Liu, Yun

2018-02-21

Nanoparticles typically have an inherent wide size distribution that may affect the performance and reliability of many nanomaterials. Because the synthesis and purification of nanoparticles with desirable sizes are crucial to the applications of nanoparticles in various fields including medicine, biology, health care, and energy, there is a great need to search for more efficient and generic methods for size-selective nanoparticle purification/separation. Here we propose and conclusively demonstrate the effectiveness of a size-selective particle purification/separation method based on the critical Casimir force. The critical Casimir force is a generic interaction between colloidal particles near the solvent critical point and has been extensively studied in the past several decades due to its importance in reversibly controlling the aggregation and stability of colloidal particles. Combining multiple experimental techniques, we found that the critical Casimir force-induced aggregation depends on relative particle sizes in a system with larger ones aggregating first and the smaller ones remaining in solution. Based on this observation, a new size-dependent nanoparticle purification/separation method is proposed and demonstrated to be very efficient in purifying commercial silica nanoparticles in the lutidine/water binary solvent. Due to the ubiquity of the critical Casimir force for many colloidal particles in binary solvents, this method might be applicable to many types of colloidal particles.

Worries and concerns experienced by nurse specialists during inter-hospital transports of critically ill patients: a critical incident study.

Science.gov (United States)

Gustafsson, Marcus; Wennerholm, Sara; Fridlund, Bengt

2010-06-01

Inter-hospital patient transports are required around the clock. During these transports it is the responsibility of the accompanying nurse specialists to ensure their patient's safety, while at the same time providing optimal nursing care in an unusual and often stressful situation. The aim of this study was to explore and describe the nurse specialists' cause of worries and concerns (WaC) and how they manage these. An explorative and qualitative design based on the critical incident technique was used. Interviews were conducted with 30 nurse specialists within the fields of anaesthetic, intensive and pre-hospital care in the south of Sweden. WaC felt by the nurse specialists were based on being unable to influence their work situation, or carry out their tasks as expected. Their responses to these unusual situations were resolved by using internal (acquired knowledge and experience) and external resources (consulting colleagues having different competences). A safe working environment improves the possibility to deliver a satisfactory work performance. Shared experiences and communication between colleagues should be encouraged; teamwork should be enhanced by the implementation of local and national training courses, and unambiguous work guidelines should be given. Copyright 2010 Elsevier Ltd. All rights reserved.

Palliative care nurses' recognition and assessment of patients with delirium symptoms: a qualitative study using critical incident technique.

Science.gov (United States)

Hosie, Annmarie; Agar, Meera; Lobb, Elizabeth; Davidson, Patricia M; Phillips, Jane

2014-10-01

Delirium is prevalent in palliative care inpatient settings and management is often challenging. Despite nurses' integral patient care role, little is known about palliative care nurses' capacity to recognise, assess and respond to patients' delirium symptoms. To explore the experiences, views and practices of inpatient palliative care nurses in delirium recognition and assessment. 30 nurses from nine Australian specialist palliative care inpatient services. Critical incident technique (CIT) guided a series of semi-structured interviews. Prior to interviews participants were given a vignette of a palliative care inpatient with an unrecognised hypoactive delirium, to prompt their recollection and recounting of a similar clinical incident. Clearly recalled and described incidents were analysed using thematic content analysis. 20 of 30 participants recalled and described 28 relevant delirium incidents. Two themes and six sub-themes provide a general description of participants' experiences, views and practice in delirium recognition and assessment. Participants experience distress related to caring for patients with delirium and express compassion and empathy for delirious patients. Enhancing their delirium knowledge, strengthening collaborative multidisciplinary team relationships and better communication are important supports. Some participants, usually those in advance practice roles, describe more comprehensive assessment capabilities that incorporate clinical expertise with whole person awareness, yet systematic and structured delirium screening and assessment processes and application of the delirium diagnosis criteria are largely missing. Use of ambiguous terminology to describe delirium symptoms contributes to ineffective practice. The findings of this study expands our understanding of how palliative care nurses' capacity to recognise and assess patients' delirium symptoms in the inpatient setting could be strengthened. Copyright © 2014 Elsevier Ltd. All

Regions of existence of two forms of the critical void fraction dependence on heat flux density at burnout

International Nuclear Information System (INIS)

Smolin, V.N.

1981-01-01

On the basis of the available experimental data considered is the burnout during the movement of steam-water flow in vertical heated tubes with internal diameter from 8 to 40 mm. Critical steam content Xsub(cr) dependences on the critical heat flux qsub(cr) in different tubes and under different pressure are analyzed. Two main regions of the weak and strong dependences Xsub(cr)=f(qsub(cr)) at burnout are found out [ru

Early diagnostics and incidence of diabetic nephropathy depending on type 1 diabetes mellitus duration

Directory of Open Access Journals (Sweden)

V.A. Maslianko

2017-03-01

Full Text Available The objective — to establish the incidence of diabetic nephropathy (DN depending on duration of type 1 diabetes mellitus (DM, and also the content of cystatin С as a marker of early kidney damage. Materials and methods. Twenty eight patients with type 1 DM were enrolled in prospective study (11 men and 17 women aged 34.8 ± 7.2 years. Clinical and functional examination included the standard evaluation of renal function, and also the study of serum level of cystatin С. Results. In 17 out of 28 patients, the indexes of glomerular filtration rate calculated using the formulas of CKD-ЕРIcreat and CKD-ЕРIcys, indicated the different stages of chronic kidneys disease. Conclusions. Determination of cystatin C level and calculation of glomerular filtration rate using this index allows diagnosing the preclinical stages of kidney dysfunction in patients with type 1 DM in the normal creatinine level in the blood and without decline in glomerular filtration rate calculated using creatinine value. According to a retrospective study, the incidence and severity of DN in patients with type 1 DM increases with disease duration of more than 10 years.

Understanding heterogeneity in social anxiety disorder: dependency and self-criticism moderate fear responses to interpersonal cues.

Science.gov (United States)

Kopala-Sibley, Daniel C; Zuroff, David C; Russell, Jennifer J; Moskowitz, D S

2014-06-01

This study examined how the personality traits of self-criticism and dependency moderated the effects of situational interpersonal cues on fear during interpersonal interactions among individuals with social anxiety disorder (SAD). We hypothesized that self-criticism would moderate the fear-inducing effects of situational self-consciousness and that dependency would moderate the fear-inducing effects of situational emotional insecurity. Forty SAD patients (Mage = 29.23) and matched community controls (Mage = 28.93) completed event-contingent record forms after each significant social interaction of over 5 min for a 20-day period. There were 20 female patients and 20 male patients in each group. Event-level self-consciousness was more strongly associated with elevations in fear among socially anxious patients who reported higher levels of self-criticism, while event-level emotional security was more strongly associated with decreases in fear among SAD patients who reported higher levels of dependency. These interactions were not found in the community sample. Findings support the application of personality-vulnerability models to understanding fear during social interactions in patients with SAD. Results also have implications for psychotherapeutic treatments of SAD. © 2013 The British Psychological Society.

Postoperative Venous Thromboembolism in Asia: A Critical Appraisal of its Incidence

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Ngoh Chin Liew

2003-07-01

Conclusion: While there is a wide variation in the incidence of DVT and VTE as reported in the Asian population, these diseases are by no means rare. The wide variation could be due to the study designs, heterogeneity of the procedures performed and the application of different diagnostic criteria. Results based on prospective studies with objective diagnostic criteria confirm the incidence of VTE as common. Routine chemoprophylaxis must be seriously considered in high-risk patients.

Activity dependent protein degradation is critical for the formation and stability of fear memory in the amygdala.

Directory of Open Access Journals (Sweden)

Timothy J Jarome

Full Text Available Protein degradation through the ubiquitin-proteasome system [UPS] plays a critical role in some forms of synaptic plasticity. However, its role in memory formation in the amygdala, a site critical for the formation of fear memories, currently remains unknown. Here we provide the first evidence that protein degradation through the UPS is critically engaged at amygdala synapses during memory formation and retrieval. Fear conditioning results in NMDA-dependent increases in degradation-specific polyubiquitination in the amygdala, targeting proteins involved in translational control and synaptic structure and blocking the degradation of these proteins significantly impairs long-term memory. Furthermore, retrieval of fear memory results in a second wave of NMDA-dependent polyubiquitination that targets proteins involved in translational silencing and synaptic structure and is critical for memory updating following recall. These results indicate that UPS-mediated protein degradation is a major regulator of synaptic plasticity necessary for the formation and stability of long-term memories at amygdala synapses.

Polarimetric Scattering Properties of Landslides in Forested Areas and the Dependence on the Local Incidence Angle

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Takashi Shibayama

2015-11-01

Full Text Available This paper addresses the local incidence angle dependence of several polarimetric indices corresponding to landslides in forested areas. Landslide is deeply related to the loss of human lives and their property. Various kinds of remote sensing techniques, including aerial photography, high-resolution optical satellite imagery, LiDAR and SAR interferometry (InSAR, have been available for landslide investigations. SAR polarimetry is potentially an effective measure to investigate landslides because fully-polarimetric SAR (PolSAR data contain more information compared to conventional single- or dual-polarization SAR data. However, research on landslide recognition utilizing polarimetric SAR (PolSAR is quite limited. Polarimetric properties of landslides have not been examined quantitatively so far. Accordingly, we examined the polarimetric scattering properties of landslides by an assessment of how the decomposed scattering power components and the polarimetric correlation coefficient change with the local incidence angle. In the assessment, PolSAR data acquired from different directions with both spaceborne and airborne SARs were utilized. It was found that the surface scattering power and the polarimetric correlation coefficient of landslides significantly decrease with the local incidence angle, while these indices of surrounding forest do not. This fact leads to establishing a method of effective detection of landslide area by polarimetric information.

Incident energy and target dependence of interaction cross sections and density distribution of neutron drip-line nuclei

International Nuclear Information System (INIS)

Shimoura, S.

1992-01-01

The relation between nuclear density distribution and interaction cross section is discussed in terms of Glauber model. Based on the model, density distribution of neutron drip-line nucleus 11 Be and 11 Li is determined experimentally from incident energy dependence of interaction cross sections of 11 Be and 11 Li on light targets. The obtained distributions have long tails corresponding to neutron halos of loosely bound neutrons. (Author)

Angular dependence of the upper critical field in Bi2Sr2CuO6+δ

International Nuclear Information System (INIS)

Vedeneev, S.I.; Ovchinnikov, Yu.N.

2002-01-01

The angular dependence of the upper critical field has been investigated in a wide range of temperatures in very high-quality Bi 2 Sr 2 CuO 6+δ single crystals with critical temperature ≅ 9 K in magnetic fields up to 28 T. Although the typical value of the normal state resistivity ratio ≅ 10 4 , the anisotropy ratio of the upper critical fields is much smaller. A model is proposed based on a strong anisotropy and a small transparency between superconducting layers [ru

Incidence of type 1 (insulin-dependent) diabetes mellitus in subjects 0-14 years of age in the Comunidad of Madrid, Spain.

Science.gov (United States)

Serrano Ríos, M; Moy, C S; Martín Serrano, R; Minuesa Asensio, A; de Tomás Labat, M E; Zarandieta Romero, G; Herrera, J

1990-07-01

A retrospective, population-based registry was established in the Comunidad of Madrid, Spain (total population: 4,780,572; under age 15: 1,105,243) to investigate the epidemiology of Type 1 (insulin-dependent) diabetes mellitus. Included were all cases diagnosed with diabetes between 1985 and 1988, with age onset less than 15 years, and using insulin at discharge from hospital. Using the capture-recapture method employing hospital records as the primary source and membership files of the Spanish Diabetic Association as the secondary source, the ascertainment was 90%. The overall annual incidence was estimated to be 11.3/100,000 (Poison 95% confidence interval: 10.3-12.4). There was no temporal increase in incidence, nor was there a significant sex difference in incidence rates, either overall or by year. The seasonal onset pattern showed the highest incidence in winter (December-February) and lowest in summer (June-August) (r = 7.36, p less than 0.05). The age-adjusted (world standard) incidence of 10.9/100,000 was inconsistent with the hypothesis of a north-south gradient in diabetes risk.

Flow rate dependency of critical wall shear stress in a radial-flow cell

DEFF Research Database (Denmark)

Detry, J.G.; Jensen, Bo Boye Busk; Sindic, M.

2009-01-01

In the present work, a radial-flow cell was used to study the removal of starch particle aggregates from several solid substrates (glass, stainless steel, polystyrene and PTFE) in order to determine the critical wall shear stress value for each case. The particle aggregates were formed by aspersion...... of a water or ethanol suspension of starch granules on the surfaces. Depending on the substrate and on the suspending liquid, the aggregates differed in size and shape. Aggregate removal was studied at two flow rates. At the lower flow rate (Re-inlet = 955), the values of critical wall shear stress...... for the different surfaces suggested that capillary forces were, for all of them, playing an important role in aggregate adhesion since aqueous based aggregates were always more difficult to remove. At the higher flow rate (Re-inlet = 2016) the critical wall shear stress increased as a result of the change...

Heat treatment effect on the strain dependence of the critical current for an internal-tin processed Nb3Sn strand

International Nuclear Information System (INIS)

Oh, Sangjun; Park, Soo-Hyeon; Lee, Chulhee; Choi, Heekyung; Kim, Keeman

2010-01-01

A comparative study on the effects of heat treatment, especially, the duration of the A15 reaction temperature plateau on the strain dependence of the critical current for an internal-tin processed Nb 3 Sn strand has been carried out. The strain dependence of the critical current is measured by a variable temperature Walter spiral probe that we have developed. It was shown that prolonged heat treatment can be a very effective way to improve the strain dependency. For a quantitative analysis, the measured data were analyzed with various proposed scaling laws: the scaling law based on strong-coupling theory, the modified deviatoric strain scaling law, and the interpolative scaling law. We found that there is a slight increase in the critical temperature and a substantial improvement in the maximum pinning force. The origin of improved strain dependency is further discussed.

Fluctuation limit theorems for age-dependent critical binary branching systems

Directory of Open Access Journals (Sweden)

Murillo-Salas Antonio

2011-03-01

Full Text Available We consider an age-dependent branching particle system in ℝd, where the particles are subject to α-stable migration (0 < α ≤ 2, critical binary branching, and general (non-arithmetic lifetimes distribution. The population starts off from a Poisson random field in ℝd with Lebesgue intensity. We prove functional central limit theorems and strong laws of large numbers under two rescalings: high particle density, and a space-time rescaling that preserves the migration distribution. Properties of the limit processes such as Markov property, almost sure continuity of paths and generalized Langevin equation, are also investigated.

Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis.

Science.gov (United States)

Arora, V; Johnson, J; Lovinger, D; Humphrey, H J; Meltzer, D O

2005-12-01

The transfer of care for hospitalized patients between inpatient physicians is routinely mediated through written and verbal communication or "sign-out". This study aims to describe how communication failures during this process can lead to patient harm. In interviews employing critical incident technique, first year resident physicians (interns) described (1) any adverse events or near misses due to suboptimal preceding patient sign-out; (2) the worst event due to suboptimal sign-out in which they were involved; and (3) suggestions to improve sign-out. All data were analyzed and categorized using the constant comparative method with independent review by three researchers. Twenty six interns caring for 82 patients were interviewed after receiving sign-out from another intern. Twenty five discrete incidents, all the result of communication failures during the preceding patient sign-out, and 21 worst events were described. Inter-rater agreement for categorization was high (kappa 0.78-1.00). Omitted content (such as medications, active problems, pending tests) or failure-prone communication processes (such as lack of face-to-face discussion) emerged as major categories of failed communication. In nearly all cases these failures led to uncertainty during decisions on patient care. Uncertainty may result in inefficient or suboptimal care such as repeat or unnecessary tests. Interns desired thorough but relevant face-to-face verbal sign-outs that reviewed anticipated issues. They preferred legible, accurate, updated, written sign-out sheets that included standard patient content such as code status or active and anticipated medical problems. Communication failures during sign-out often lead to uncertainty in decisions on patient care. These may result in inefficient or suboptimal care leading to patient harm.

A critical review of literature on-the-job training’s incidence and its effects in Company

Directory of Open Access Journals (Sweden)

Lorena Alikaj

2017-03-01

Full Text Available This theoretical article aims to collect and review critically some empirical findings and researches on the incidence of employer training and the economic effects of it on company. It’s aimed to clarify the type of training that companies ensure on the work place, the frequency of training. Is it true that after training, employees have higher chances of promotion and mobility? What are the benefits from the point of view of the companies for them? Is it measurable this investment in human capital? Knowing correctly the literature related to the questions above, it helps the policymakers to formulate the right policies for equality of earnings and accessing on-the-job training, decrease chances for gender discrimination and increase the long run return of the company that makes training among employees. There is a higher interest studying the incidence, determinants, and effects of company training, supported by more reliable data and sophisticated research techniques and instruments. On the other hand, as the interest for the topic increases, so the confusion surrounding this literature does. There are a few empirical articles for the case of Albania. Identifying the right literature and developments on the topic should help the other researchers to explore the field and to contribute with updated findings for Albania’s job market.

Multiple scattering in grazing-incidence X-ray diffraction: impact on lattice-constant determination in thin films

Energy Technology Data Exchange (ETDEWEB)

Resel, Roland, E-mail: roland.resel@tugraz.at; Bainschab, Markus; Pichler, Alexander [Graz University of Technology, Graz (Austria); Dingemans, Theo [Delft University of Technology, Delft (Netherlands); Simbrunner, Clemens [Johannes Kepler University, Linz (Austria); University of Bremen, Bremen (Germany); Stangl, Julian [Johannes Kepler University, Linz (Austria); Salzmann, Ingo [Humboldt University, Berlin (Germany)

2016-04-20

The use of grazing-incidence X-ray diffraction to determine the crystal structure from thin films requires accurate positions of Bragg peaks. Refraction effects and multiple scattering events have to be corrected or minimized. Dynamical scattering effects are observed in grazing-incidence X-ray diffraction experiments using an organic thin film of 2,2′:6′,2′′-ternaphthalene grown on oxidized silicon as substrate. Here, a splitting of all Bragg peaks in the out-of-plane direction (z-direction) has been observed, the magnitude of which depends both on the incidence angle of the primary beam and the out-of-plane angle of the scattered beam. The incident angle was varied between 0.09° and 0.25° for synchrotron radiation of 10.5 keV. This study reveals comparable intensities of the split peaks with a maximum for incidence angles close to the critical angle of total external reflection of the substrate. This observation is rationalized by two different scattering pathways resulting in diffraction peaks at different positions at the detector. In order to minimize the splitting, the data suggest either using incident angles well below the critical angle of total reflection or angles well above, which sufficiently attenuates the contributions from the second scattering path. This study highlights that the refraction of X-rays in (organic) thin films has to be corrected accordingly to allow for the determination of peak positions with sufficient accuracy. Based thereon, a reliable determination of the lattice constants becomes feasible, which is required for crystallographic structure solutions from thin films.

Angular and magnetic field dependences of critical current in irradiated YBaCuO single crystals

International Nuclear Information System (INIS)

Petrusenko, Yu.

2010-01-01

The investigation of mechanisms responsible for the current-carrying capability of irradiated high-temperature superconductors (HTSC) was realized. For the purpose, experiments were made to investigate the effect of point defects generated by high-energy electron irradiation on the critical temperature and the critical current in high-Tc superconducting single crystals YBa 2 Cu 3 O 7-x . The transport current density measured in HTSC single crystals YBa 2 Cu 3 O 7-x by the dc-method was found to exceed 80000 A/cm 2 . The experiments have demonstrated a more than 30-fold increase in the critical current density in single crystals irradiated with 2.5 MeV electrons to a dose of 3·10 18 el/cm 2 . Detailed studies were made into the anisotropy of critical current and the dependence of critical current on the external magnetic field strength in irradiated single crystals. A high efficiency of point defects as centers of magnetic vortex pinning in HTSC single crystals was first demonstrated.

[The state of pediatric anesthesia in Japan: an analysis of the Japanese society of anesthesiologists survey of critical incidents in the operating room].

Science.gov (United States)

Irita, Kazuo; Tsuzaki, Koichi; Sawa, Tomohiro; Sanuki, Michiyoshi; Nakatsuka, Hideki; Makita, Koshi; Morita, Kiyoshi

2007-01-01

The Japanese Society of Anesthesiologists (JSA) survey of critical incidents in the operating room and other reports have shown that pediatric patients undergoing anesthesia are at an increased risk. Purpose was to examine the state of pediatric anesthesia in Japan. This might clarify the role of children's hospitals for pediatric anesthesia, and the relationship between critical incidents and volume of pediatric anesthetic procedures. The JSA has conducted annual surveys of critical incidents in the operating room by sending to and collecting confidential questionnaires from all JSA Certified Training Hospitals. From 1999 to 2003, 342,840 pediatric (0-5 yr) anesthetic procedures were registered. During this period, only 15 cardiac arrests and 3 deaths within 7 postoperative days totally attributable to anesthetic management were reported. Therefore, we analyzed cardiac arrests and deaths due to all etiologies. The hospitals were classified as children's hospitals, university hospitals, and other hospitals, and the incidence of cardiac arrest, the recovery rate from cardiac arrest without any sequelae, and the mortality rate were compared according to types of the hospitals. The relationship between death due to intraoperative critical incidents and the volume of pediatric anesthetic procedures was examined using data from the 2003 survey, the recovery rate of which was 85.7%. In 2003, 739 JSA Certified Training Hospitals responded to the survey: 7 children's hospitals, 109 university hospitals, and 623 other hospitals. Among these hospitals, 707 and 270 hospitals conducted pediatric and newborn (anesthesia, respectively. In 2003, 4,630 newborn, 17,890 infant (risks among the hospital groups, and the 95% confidential interval (CI) was shown. The Chi square test was used to compare the background of patients with cardiac arrest. P values less than 0.05 were considered significant. In 2003, 95.7% and 36.5% of JSA Certified Training Hospitals which responded to the

Financial services employees' experience of peer-led and clinician-led critical incident stress debriefing following armed robberies.

Science.gov (United States)

Simms-Ellis, R; Madill, A

2001-01-01

This study investigates financial services employees' experience of critical incident stress debriefing (CISD) and their views about peers and clinicians as facilitators. Semi-structured interview accounts of four participants who had experienced both peer-led and clinician-led CISD were analyzed using grounded theory. A core category, ambivalence, permeated each interview and divided into two poles: pathologizing and normalizing. The most frequently occurring sub-category was a dislike of professionalism. Participants preferred the peer debriefer who was perceived to have more personal involvement and with whom they felt more empowered and understood. The findings suggest that the status of the debriefer as 'peer' or 'clinician' may be a crucial variable in the effectiveness of CISD and should be considered when reviewing the outcome literature.

Dealing with aggressive methadone patients in community pharmacy: a critical incident study.

Science.gov (United States)

Irwin, Amy; Laing, Christianne; Mearns, Kathryn

2012-01-01

Community pharmacists are an important link between methadone patients and the health service in the United Kingdom. However, many pharmacists feel ill prepared to deal with methadone patients, with aggressive behavior a particular concern. To assess the perceived impact of methadone patient aggression on pharmacy practice. Sixteen registered pharmacists with a minimum of 3 years' work experience were recruited from within 3 Scottish health boards. Critical incident interviews were conducted to assess pharmacist behavior during an interaction with an aggressive methadone patient. Factors considered by pharmacists to have a negative impact on an interaction with an aggressive methadone patient included intoxication of the patient, the presence of a new or an inexperienced pharmacist, and a restricted time frame for dispensing methadone. Positive factors when dealing with aggressive patients were authoritative behavior by the pharmacist, a separate dispensing area for methadone patients, or a solid counter and a positive relationship between pharmacist and patient. Aggression from methadone patients is a risk when dispensing methadone. However, action can be taken by the pharmacist to minimize the impact of that aggression on pharmacy practice. The provision of further training and support, particularly to inexperienced pharmacists, could further reduce the negative impact of patient aggression. The present study indicates that such training could be based on nontechnical skills to strengthen current leadership and teamwork behaviors. Copyright © 2012 Elsevier Inc. All rights reserved.

Critical infrastructure protection

Energy Technology Data Exchange (ETDEWEB)

Bradley, F. [Canadian Electricity Association, Toronto, ON (Canada)

2003-04-01

The need to protect critical electrical infrastructure from terrorist attacks, or other physical damage, including weather related events, or the potential impact of computer viruses and other attacks on IT resources are discussed. Activities of the North American Electric Reliability Council (NERC) are highlighted which seek to safeguard the North American bulk electric power system principally through the Information Sharing and Analysis Sector (ES-ISAC). ES-ISAC serves the electricity sector by facilitating communication between electric sector participants, federal government and other critical infrastructure industries by disseminating threat indications, analyses and warnings, together with interpretations, to assist the industry in taking infrastructure protection actions. Attention is drawn to the numerous cyber incidents in recent years, which although resulted in no loss of service to electricity customers so far, in at least one instance (the January 25th SOL-Slammer worm incident) resulted in degradation of service in a number of sectors, including financial, transportation and telecommunication services. The increasing frequency of cyber-based attacks, coupled with the industry's growing dependence on e-commerce and electronic controls, are good reasons to believe that critical infrastructure protection (CIP) poses a serious challenge to the industry's risk management practices. The Canadian Electricity Association (CEA) is an active participant in ES-ISAC and works cooperatively with a range of partners, such as the Edison Electric Institute and the American Public Power Association to ensure coordination and effective protection program delivery for the electric power sector. The Early Warning System (EWS) developed by the CIP Working Group is one of the results of this cooperation. EWS uses the Internet, e-mail, web-enabled cell phones and Blackberry hand-held devices to deliver real-time threat information to members on a 24/7 basis. EWS

Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents.

Science.gov (United States)

DeFraia, G S

2015-07-01

Psychologically traumatic workplace events (known as critical incidents) occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions. To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents. Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events. Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident. Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.

Why did you decide to become a Geoscience Major: A Critical Incident Study for the Development of Recruiting Programs for Inspiring Interests in the Geosciences Amongst Pre-College Students

Science.gov (United States)

Carrick, T. L.; Miller, K. C.; Levine, R.; Martinez-Sussmann, C.; Velasco, A. A.

2011-12-01

Anecdotally, it is often stated that the majority of students that enter the geosciences usually do so sometime after their initial entrance into college. With the objective of providing concrete and useful information for individuals developing programs for inspiring interest in the Geosciences amongst pre-college students and trying to increase the number of freshman Geoscience majors, we conducted a critical incident study. Twenty-two students, who were undergraduate or graduate Geoscience majors, were asked, "Why did you decide to major in the Geosciences?" in a series of interviews. Their responses were then used to identify over 100 critical incidents, each of which described a specific behavior that was causally responsible for a student's choice to major in Geoscience. Using these critical incidents, we developed a preliminary taxonomy that is comprised of three major categories: Informal Exposure to the Geosciences (e.g., outdoor experiences, family involvement), Formal Exposure to the Geosciences (e.g., academic experiences, program participation) and a Combined Informal and Formal Exposure (e.g., media exposure). Within these three main categories we identified thirteen subcategories. These categories and subcategories, describe, classify, and provide concrete examples of strategies that were responsible for geosciences career choices. As a whole, the taxonomy is valuable as a new, data-based guide for designing geosciences recruitment programs for the pre-college student population.

Criticality accident of nuclear fuel facility. Think back on JCO criticality accident

International Nuclear Information System (INIS)

Naito, Keiji

2003-09-01

This book is written in order to understand the fundamental knowledge of criticality safety or criticality accident of nuclear fuel facility by the citizens. It consists of four chapters such as critical conditions and criticality accident of nuclear facility, risk of criticality accident, prevention of criticality accident and a measure at an occurrence of criticality accident. A definition of criticality, control of critical conditions, an aspect of accident, a rate of incident, damage, three sufferers, safety control method of criticality, engineering and administrative control, safety design of criticality, investigation of failure of safety control of JCO criticality accident, safety culture are explained. JCO criticality accident was caused with intention of disregarding regulation. It is important that we recognize the correct risk of criticality accident of nuclear fuel facility and prevent disasters. On the basis of them, we should establish safety culture. (S.Y.)

practice gap in critical care nursing students

African Journals Online (AJOL)

Guided reflection as a tool to deal with the theory– practice gap in critical care ... was used during semi-structured interviews during the data collection process. ... a description of incidents experienced, critical analysis of knowledge, critical ...

Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents

Directory of Open Access Journals (Sweden)

GS DeFraia

2015-07-01

Full Text Available Background: Psychologically traumatic workplace events (known as critical incidents occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions. Objective: To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents. Methods: Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events. Results: Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident. Conclusion: Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.

Five-year experience of critical incidents associated with patient-controlled analgesia in an Irish University Hospital.

LENUS (Irish Health Repository)

Ahmad, I

2012-02-01

BACKGROUND: Patient-controlled analgesia (PCA) is a common and effective means of managing post-operative pain. We sought to identify factors that may lead to critical incidents (CIs) in patient safety when using PCA in our institution. METHODS: An observational study of prospectively collected data of patients who received PCA from 2002 to 2006 was performed. All CIs were documented and analysed by staff members of the acute pain service (APS). Cause analysis of CIs was undertaken to determine if measures can be instituted to prevent recurrence of similar events. RESULTS: Over eight thousand patients (8,240) received PCA. Twenty-seven CIs were identified. Eighteen were due to programming errors. Other CIs included co-administration of opioids and oversedation. CONCLUSION: In our institution, the largest contributory factor to CIs with PCAs was programming error. Strategies to minimize this problem include better education and surveillance.

Sample-length dependence of the critical current of slightly and significantly bent-damaged Bi2223 superconducting composite tape

International Nuclear Information System (INIS)

Ochiai, S; Fujimoto, M; Okuda, H; Oh, S S; Ha, D W

2007-01-01

The local critical current along a sample length is different from position to position in a long sample, especially when the sample is damaged by externally applied strain. In the present work, we attempted to reveal the relation of the distribution of the local critical current to overall critical current and the sample-length dependence of critical current for slightly and significantly damaged Bi2223 composite tape samples. In the experiment, 48 cm long Bi2223 composite tape samples, composed of 48 local elements with a length of 1 cm and 8 parts with a length 6 cm, were bent by 0.37 and 1.0% to cause slight and significant damage, respectively. The V-I curve, critical current (1 μV cm -1 criterion) and n value were measured for the overall sample as well as for the local elements and parts. It was found that the critical current distributions of the 1 cm elements at 0.37 and 1.0% bending strains are described by the three-parameter- and bimodal Weibull distribution functions, respectively. The critical current of a long sample at both bending strains could be described well by substituting the distributed critical current and n value of the short elements into the series circuit model for voltage generation. Also the measured relation of average critical current to sample length could be reproduced well in the computer by a Monte Carlo simulation method. It was shown that the critical current and n value decrease with increasing sample length at both bending strains. The extent of the decrease in critical current with sample length is dependent on the criterion of the critical current; the critical current decreases only slightly under the 1 μV cm -1 criterion which is not damage-sensitive, while it decreases greatly with increasing sample length under damage-sensitive criteria such as the 1 μV one

Incidence of Type II CRISPR1-Cas Systems in Enterococcus Is Species-Dependent.

Directory of Open Access Journals (Sweden)

Casandra Lyons

Full Text Available CRISPR-Cas systems, which obstruct both viral infection and incorporation of mobile genetic elements by horizontal transfer, are a specific immune response common to prokaryotes. Antiviral protection by CRISPR-Cas comes at a cost, as horizontally-acquired genes may increase fitness and provide rapid adaptation to habitat change. To date, investigations into the prevalence of CRISPR have primarily focused on pathogenic and clinical bacteria, while less is known about CRISPR dynamics in commensal and environmental species. We designed PCR primers and coupled these with DNA sequencing of products to detect and characterize the presence of cas1, a universal CRISPR-associated gene and proxy for the Type II CRISPR1-Cas system, in environmental and non-clinical Enterococcus isolates. CRISPR1-cas1 was detected in approximately 33% of the 275 strains examined, and differences in CRISPR1 carriage between species was significant. Incidence of cas1 in E. hirae was 73%, nearly three times that of E. faecalis (23.6% and 10 times more frequent than in E. durans (7.1%. Also, this is the first report of CRISPR1 presence in E. durans, as well as in the plant-associated species E. casseliflavus and E. sulfureus. Significant differences in CRISPR1-cas1 incidence among Enterococcus species support the hypothesis that there is a tradeoff between protection and adaptability. The differences in the habitats of enterococcal species may exert varying selective pressure that results in a species-dependent distribution of CRISPR-Cas systems.

Congestive heart failure, spouses' support and the couple's sleep situation: a critical incident technique analysis.

Science.gov (United States)

Broström, Anders; Strömberg, Anna; Dahlström, Ulf; Fridlund, Bengt

2003-03-01

Sleep related breathing disorders are common as well as a poor prognostic sign associated with higher mortality in patients with congestive heart failure (CHF). These patients often have a shorter total duration of sleep, disturbed sleep structure and increased daytime sleepiness, which can negatively affect all dimensions of the life situation. The spouse has an important role in supporting the patient in relation to sleep disorders, but this role may be adversely affected by the sleep situation of the couple. The aim of this study was to describe decisive situations that influence spouses' support to patients with CHF in relation to the couple's sleep situation. A qualitative descriptive design using critical incident technique was employed. Incidents were collected by means of interviews with 25 spouses of patients with CHF, strategically selected from two hospital-based specialist clinics in southern Sweden. Two main areas emerged in the analysis: support stimulating situations and support inhibiting situations. Support stimulating situations described how spouses' support was positively affected by their own adaptation in psychosocial or practical situations, and receiving help from others. Support inhibiting situations described how the spouses' support was negatively affected by sleep disturbances as a result of the patient's symptoms, anxiety in relation to the disease, limitations as a result of the sleeping habits, dissatisfaction with care related to the sleep situation, and being left to cope alone with the problems. An increased understanding of the stimulating and inhibiting situations influencing spouses' support for patients with CHF can guide health care personnel in deciding if an intervention is needed to improve the sleep situation for patient and spouse.

The Development of Self-Criticism and Dependency in Early Adolescence and Their Role in the Development of Depressive and Anxiety Symptoms.

Science.gov (United States)

Kopala-Sibley, Daniel C; Zuroff, David C; Hankin, Benjamin L; Abela, John R Z

2015-08-01

According to Blatt and others (e.g., A. T. Beck), self-definition, or one's sense of self, and one's sense of relatedness to others represent core lifespan developmental tasks. This study examined the role of events pertaining to self-definition or relatedness in the development of personality traits from each domain (self-criticism and dependency), and their relationship to the development of depressive and anxiety symptoms. Two hundred seventy-six early adolescents completed a measure of self-criticism and dependency at baseline and again 24 months later, along with measures of depressive and anxiety symptoms. Every 3 months, participants completed a measure of life events, which were coded as self-definitional or relatedness oriented (80% rater agreement, kappa = .70). Structural equation models showed that self-definitional events predicted increases in self-criticism, which in turn predicted increases in depressive symptoms, whereas relatedness events predicted increases in dependency, although dependency was unrelated to change in symptoms. © 2015 by the Society for Personality and Social Psychology, Inc.

Exponential temperature dependence of the critical transport current in Y-Ba-Cu-O thin films

International Nuclear Information System (INIS)

Yom, S.S.; Hahn, T.S.; Kim, Y.H.; Chu, H.; Choi, S.S.

1989-01-01

We have measured the critical currents in rf-sputtered YBa 2 Cu 3 O/sub 7-x/ thin films deposited on polycrystalline yttria-stabilized zirconia substrates as a function of temperature down to 10 K. The dependence of the granular films at low temperature indicated exponential behavior which is similar to the superconductor-normal metal-superconductor (S-N-S) type tunneling junctions. For the films with a grain size of approximately 1 μm, we observed two exponential decay constants, which suggest that Josephson junctions limiting the transport critical current are possible both at the grain boundaries and at twin boundaries

Angular dependence of critical current density and magnetoresistance of sputtered high-T{sub c}-films

Energy Technology Data Exchange (ETDEWEB)

Geerkens, A.; Frenck, H.J.; Ewert, S. [Technical Univ. of Cottbus (Germany)] [and others

1994-12-31

The angular dependence of the critical current density and the magnetoresistance of high-T{sub c}-films in high and low magnetic fields and for different temperatures were measured to investigate the flux pinning and the superconducting properties. A comparison of the results for the different superconductors shows their increasing dependence on the angle {Theta} between the magnetic field and the c-axis of the film due to the anisotropy of the chosen superconductor. Furthermore the influence of the current direction to the {Theta}-rotation plane is discussed.

Dependency, self-criticism and negative affective responses following imaginary rejection and failure threats: meaning-making processes as moderators or mediators.

Science.gov (United States)

Besser, Avi; Priel, Beatriz

2011-01-01

This study evaluated the intervening role of meaning-making processes in emotional responses to negative life events based on Blatt's (1974, 2004) formulations concerning the role of personality predispositions in depression. In a pre/post within-subject study design, a community sample of 233 participants reacted to imaginary scenarios of interpersonal rejection and achievement failure. Meaning-making processes relating to threats to self-definition and interpersonal relatedness were examined following the exposure to the scenarios. The results indicated that the personality predisposition of Dependency, but not Self-Criticism predicted higher levels of negative affect following the interpersonal rejection event, independent of baseline levels of negative affect. This effect was mediated by higher levels of negative meaning-making processes related to the effect of the interpersonal rejection scenario on Dependent individuals' senses of interpersonal relatedness and self-worth. In addition, both Self-Criticism and Dependency predicted higher levels of negative affect following the achievement failure event, independent of baseline levels of negative affect. Finally, the effect of Self-Criticism was mediated by higher levels of negative meaning-making processes related to the effect of the achievement failure scenario on self-critical individuals' senses of self-definition.

Design criteria and principles for criticality detection and alarm systems

International Nuclear Information System (INIS)

Delafield, H.J.; Clifton, J.J.

1984-10-01

The report gives design principles and criteria for criticality detection and alarm systems based on earlier work and revised in the light of more recent experience. In particular, account is taken of the developments which have taken place in the field of radiation detection and in the understanding of the different types of criticality excursion. General guidance is given on the principles to apply in deciding upon the need for a criticality system. The characteristics of a criticality incident are described in terms of the minimum incident of concern, and the radiation field. Criteria for the threshold of detection of a criticality incident are then derived and the methods of detection considered. The selection and siting of criticality detectors is discussed, and design principles are given for alarm systems. Finally, testing and post-alarm procedures are outlined, followed by a summary of the principal recommendations. The supporting Appendices include a discussion of reliability and a summary of radiation detector characteristics. (author)

Analysis of Critical Infrastructure Dependencies and Interdependencies

Energy Technology Data Exchange (ETDEWEB)

Petit, Frederic [Argonne National Lab. (ANL), Argonne, IL (United States); Verner, Duane [Argonne National Lab. (ANL), Argonne, IL (United States); Brannegan, David [Argonne National Lab. (ANL), Argonne, IL (United States); Buehring, William [Argonne National Lab. (ANL), Argonne, IL (United States); Dickinson, David [Argonne National Lab. (ANL), Argonne, IL (United States); Guziel, Karen [Argonne National Lab. (ANL), Argonne, IL (United States); Haffenden, Rebecca [Argonne National Lab. (ANL), Argonne, IL (United States); Phillips, Julia [Argonne National Lab. (ANL), Argonne, IL (United States); Peerenboom, James [Argonne National Lab. (ANL), Argonne, IL (United States)

2015-06-01

The report begins by defining dependencies and interdependencies and exploring basic concepts of dependencies in order to facilitate a common understanding and consistent analytical approaches. Key concepts covered include; Characteristics of dependencies: upstream dependencies, internal dependencies, and downstream dependencies; Classes of dependencies: physical, cyber, geographic, and logical; and Dimensions of dependencies: operating environment, coupling and response behavior, type of failure, infrastructure characteristics, and state of operations From there, the report proposes a multi-phase roadmap to support dependency and interdependency assessment activities nationwide, identifying a range of data inputs, analysis activities, and potential products for each phase, as well as key steps needed to progress from one phase to the next. The report concludes by outlining a comprehensive, iterative, and scalable framework for analyzing dependencies and interdependencies that stakeholders can integrate into existing risk and resilience assessment efforts.

Dependence of Subduction Zone seismicity on Strain-Rate-Dependent Critical Homologous Temperature

Science.gov (United States)

Davis, P. M.

2016-12-01

Earthquakes mainly occur in crust or mantle that is below a critical temperature for the tectonic strain-rate, such that stress builds up to the breaking point before it can relax due to creep. Then long-range stress correlation gives rise to power law seismicity with large events. The limiting temperature depends on pressure, which is taken into account by finding a critical homologous temperature THc=T/TM above which earthquakes are rarely observed. We find that THc for ocean plates is ˜0.55. For California earthquakes, it is also close to 0.55. The uppermost mantle layer of oceanic plates of thickness ˜50 km is composed of harzburgite and depleted peridotite from which basalt has been removed to form ocean crust. Thus it has a higher melting temperature than the peridotite of the surrounding mantle, or the lower halves of plates. Thicknesses of seismicity in deep subduction zones, determined from 2D polynomial fits to a relocated catalog, are ˜50 km, which suggests that the earthquake channel is confined to this layer. We construct models to find homologous temperatures in slabs, and find that seismicity thicknesses are also, on average, confined to TH ≤ 0.55 ± 0.05. The associated rheology is compared with that obtained from flexure models of ocean lithosphere. The brittle-ductile transition occurs where viscosity drops from high values in the cold cores of slabs to values of 1022 to $1023 Pa s, i.e., where creep strain-rates become comparable to tectonic rates. The cutoff for deep earthquakes is not sharp. However they appear unlikely to occur if homologous temperature is high TH>0.55. Exceptions to the rule are anomalously deep earthquakes such as those beneath the Iceland and the Hawaiian hotspots, and the Newport Inglewood Fault. These are smaller events with short-range stress correlation, and can be explained if strain-rates are 2 to 3 orders of magnitude higher than those associated with earthquakes located where TH ≤0.55. We conclude that the

Incidence of bruxism in TMD population.

Science.gov (United States)

Chandwani, Briesh; Ceneviz, Caroline; Mehta, Noshir; Scrivani, Steven

2011-01-01

The objective of the study presented here was to examine the incidence of bruxism in patients suffering from temporomandibular disorders. Two cohorts of patients suffering from temporomandibular disorders were evaluated. One group, composed of 163 patients, was asked specifically about the occurrence of bruxism, while the other group, composed of 200 patients, was not specifically asked about bruxism (self-reporting). The incidence of bruxism was only 20.5% for the group that only self-reported bruxism, while the incidence was 65% when asked specifically about bruxism. It is critical to ask specifically about bruxism. Patients are more likely to report bruxism when asked specifically about it. It is important to incorporate this as part of a TMD evaluation.

Sex-dependent independent prediction of incident diabetes by depressive symptoms.

Science.gov (United States)

Akbaş-Şimşek, Tuğba; Onat, Altan; Kaya, Adnan; Tusun, Eyyup; Yüksel, Hüsniye; Can, Günay

2017-12-01

To study the predictive value of depressive symptoms (DeprSs) in a general population of Turkey for type 2 diabetes. Responses to three questions served to assess the sense of depression. Cox regression analyses were used regarding risk estimates for incident diabetes, after exclusion of prevalent cases of diabetes. Mean follow-up consisted of 5.15 (±1.4) years. Depressive symptoms were present at baseline in 16.2% of the whole study sample, threefold in women than men. Reduced physical activity grade was the only significant covariate at baseline in men, while younger age and lower blood pressure were significantly different in women compared with those without DeprS. In men, presence of DeprS predicted incident diabetes at a significant 2.58-fold relative risk (95% confidence interval 1.03; 6.44), after adjustment for age, systolic blood pressure, and antidepressant drug usage. When further covariates were added, waist circumference remained the only significant predictor, while DepS was attenuated to a relative risk of 2.12 (95% confidence interval 0.83; 5.40). DeprS was not associated with diabetes in women, whereas antidepressant drug usage only tended to be positively associated. Gender difference existed in the relationship between DeprS and incident diabetes. DeprS predicted subsequent development of diabetes in men alone, not in women. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

An exploration of GPs' use of MRI: a critical incident study.

Science.gov (United States)

Robling, M; Kinnersley, P; Houston, H; Hourihan, M; Cohen, D; Hale, J

1998-06-01

Direct access to Magnetic Resonance Imaging (MRI) is becoming available to GPs in the UK, offering major benefits for the improved diagnosis and management of certain clinical conditions. Variations in usage of this service may be large, and effective locally produced guidelines are not currently available. The Department of General Practice is conducting a research programme to develop and evaluate methods to optimize MRI use by GPs. We aimed to describe the current use of MRI by GPs in South Glamorgan; to summarize their reasons for requesting MRI; and to produce criteria to assess the appropriateness of magnetic resonance (MR) scan requests. Using the critical incident technique, 25 GPs were interviewed about recent scans requested for patients with knee and lumbar spine complaints. A local panel of primary and secondary care doctors was convened to develop criteria for assessing MR scan requests. Sixty-two scan requests were discussed. Doctors' reasons for requesting MR scans were identified and classified. Reasons for requests included personal, contextual and biomedical variables. Fifteen patients (24%) were managed in primary care following MRI when otherwise they would have been referred. When referrals were made, GPs felt able to reinforce the request and occasionally to direct the patient somewhere more appropriate. The panel reviewed the interview data to produce objective criteria to assess scan requests. The criteria reflect the relative importance of non-biomedical variables in the decision to request MRI. The study identified those reasons which are important to GPs when requesting MR scans and the impact of this new technology upon patient management. Interview data have been used to inform locally developed consensus criteria, which will be made available as practice guidelines as the research programme progresses.

Above-surface neutralization of multicharged ions incident on a cesiated Au target

International Nuclear Information System (INIS)

Meyer, F.W.; Hughes, I.G.; Overbury, S.H.

1992-01-01

The critical distance above the surface at which conduction band electrons can start to neutralize incident multicharged projectiles by classical overbarrier transitions is inversely proportional to the metal work function. By varying the amount of Cs coverage on a Au single crystal target between O and 1 monolayers, the authors have been able to verify an up to 3.3 eV decrease of the surface work function, corresponding to more than a factor of two decrease relative to that tabulated for clean Au. This change should result in more than doubling the above-surface interaction time. At larger above-surface distances, however, the electron capture most likely occurs into higher principal quantum numbers of the projectile. The subsequent de-excitation cascade by which inner shells of the projectiles are populated may thus require more time. The authors have investigated the overall effect that lowering the work function has on the above-surface component of projectile K-Auger electron emission for grazing incidence N 6+ ions interacting with cesiated Au single crystals. They will present results showing that an enhancement of this component is indeed observed, and that it is strongly dependent on incidence angle

Critical power for self-focusing of optical beam in absorbing media

Science.gov (United States)

Qi, Pengfei; Zhang, Lin; Lin, Lie; Zhang, Nan; Wang, Yan; Liu, Weiwei

2018-04-01

Self-focusing effects are of central importance for most nonlinear optical effects. The critical power for self-focusing is commonly investigated theoretically without considering a material’s absorption. Although this is practicable for various materials, investigating the critical power for self-focusing in media with non-negligible absorption is also necessary, because this is the situation usually met in practice. In this paper, the simple analytical expressions describing the relationships among incident power, absorption coefficient and focal position are provided by a simple physical model based on the Fermat principle. Expressions for the absorption dependent critical power are also derived; these can play important roles in experimental and applied research on self-focusing-related nonlinear optical phenomena in absorbing media. Numerical results, based on the nonlinear wave equation—and which can predict experimental results perfectly—are also presented, and agree quantitatively with the analytical results proposed in this paper.

An exponential scaling law for the strain dependence of the Nb3Sn critical current density

International Nuclear Information System (INIS)

Bordini, B; Alknes, P; Bottura, L; Rossi, L; Valentinis, D

2013-01-01

The critical current density of the Nb 3 Sn superconductor is strongly dependent on the strain applied to the material. In order to investigate this dependence, it is a common practice to measure the critical current of Nb 3 Sn strands for different values of applied axial strain. In the literature, several models have been proposed to describe these experimental data in the reversible strain region. All these models are capable of fitting the measurement results in the strain region where data are collected, but tend to predict unphysical trends outside the range of data, and especially for large strain values. In this paper we present a model of a new strain function, together with the results obtained by applying the new scaling law on relevant datasets. The data analyzed consisted of the critical current measurements at 4.2 K that were carried out under applied axial strain at Durham University and the University of Geneva on different strand types. With respect to the previous models proposed, the new scaling function does not present problems at large strain values, has a lower number of fitting parameters (only two instead of three or four), and is very stable, so that, starting from few experimental points, it can estimate quite accurately the strand behavior in a strain region where there are no data. A relationship is shown between the proposed strain function and the elastic strain energy, and an analogy is drawn with the exponential form of the McMillan equation for the critical temperature. (paper)

Strain dependence of the critical current and critical field in multifilamentary Nb3Sn composites

International Nuclear Information System (INIS)

Ekin, J.W.

1979-01-01

High-J/sub c/ multifilamentary Nb 3 Sn superconductors with widely varying amounts of prestrain and critical field values can be characterized fairly accurately by a single normalized critical field-strain relationship. Such a relationship permits first order prediction of critical-current degradation at arbitrary magnetic field magnitudes with knowledge of only two parameters for any conductor, the prestrain and the maximum critical field. Some of the conductor-fabrication factors affecting the parameters are considered

Incident ion charge state dependence of electron emission during slow multicharged ion-surface interactions

International Nuclear Information System (INIS)

Hughes, I.G.; Zeijlmans van Emmichoven, P.A.; Havener, C.C.; Overbury, S.H.; Robinson, M.T.; Zehner, D.M.; Meyer, F.W.

1992-01-01

Characteristic variations in the total electron yield γ as a function of crystal azimuthal orientation are reported for slow N 2+ , N 5+ and N 6+ ions incident on a Au(011) single crystal, together with measurements of γ as a function of incident ion velocity. Kinetic electron emission is shown to arise predominantly in close collisions between incident ions and target atoms, and potential electron emission is found to be essentially constant within our present velocity range. The incident ion charge state is shown to play no role in kinetic electron emission. Extremely fast neutralization times of the order of 10 - 15 secs are needed to explain the observations

The impact of critical incidents on mental health : An exploratory pilot study into the moderating effects of social support on the impact of adverse events in Dutch rescue workers.

NARCIS (Netherlands)

Bakker, H.; Gaillard, A.W.K.; van Veldhoven, M.J.P.M.

2016-01-01

This study investigated mental health- and work-related problems of 67 rescue workers (police officers and medical emergency drivers) caused by the accumulation of critical incidents during their career. Using Hobfoll’s theory of conservation of resources, this is one of the first studies in The

Thyroid cancer incidence in the Ukraine after the Chernobyl accident: comparison with spontaneous incidences

International Nuclear Information System (INIS)

Sobolev, B.; Kairo, I.; Likhtarev, I.; Heidenreich, W.F.; Jacob, P.; Goulko, G.

1997-01-01

The thyroid cancer incidence in the Ukraine among those born in the period 1968-1986 was analyzed with the aim to identify the enhancement due to the Chernobyl accident. Since any Ukrainian data referring to the time period before the accident are scarce and the variation of spontaneous incidences in other countries is immense, the Ukrainian incidences in the period 1986-1989 were used to estimate the baseline risk. Following 1990, the incidence in the southern part of the Ukraine increased by about 30%, independent of age. In the other parts the increase of the incidence depended on age at exposure. In the age group of 9-year-old children, the incidences in three regions defined as the 'high-dose area', the northern, and the middle oblasts, increased by factors of 50, 20, and 6, respectively. These rates (1991-1995) are well above spontaneous rates in other countries. In the age group of 17-year-old juveniles, the incidence increased by a factor of 6 for the 'high dose area' and in the three northern oblasts, whereas in the nine 'middle' oblasts it was similar to the incidence of the 'southern' Ukraine. These rates are within the range found in other countries. (orig.)

Angle dependence of Andreev scattering at semiconductor-superconductor interfaces

DEFF Research Database (Denmark)

Mortensen, Asger; Flensberg, Karsten; Jauho, Antti-Pekka

1999-01-01

We study the angle dependence of the Andreev scattering at a semiconductor-superconductor interface, generalizing the one-dimensional theory of Blonder, Tinkham, and Klapwijk (BTK),An increase of the momentum parallel to the interface leads to suppression of the probability of Andreev reflection...... and increase of the probability of normal reflection. We show that in the presence of a Fermi velocity mismatch between the semiconductor and the superconductor the angles of incidence and transmission are related according to the well-known Snell's law in optics. As a consequence there is a critical angle...

Manipulation of BDNF signaling modifies the experience-dependent plasticity induced by pure tone exposure during the critical period in the primary auditory cortex.

Science.gov (United States)

Anomal, Renata; de Villers-Sidani, Etienne; Merzenich, Michael M; Panizzutti, Rogerio

2013-01-01

Sensory experience powerfully shapes cortical sensory representations during an early developmental "critical period" of plasticity. In the rat primary auditory cortex (A1), the experience-dependent plasticity is exemplified by significant, long-lasting distortions in frequency representation after mere exposure to repetitive frequencies during the second week of life. In the visual system, the normal unfolding of critical period plasticity is strongly dependent on the elaboration of brain-derived neurotrophic factor (BDNF), which promotes the establishment of inhibition. Here, we tested the hypothesis that BDNF signaling plays a role in the experience-dependent plasticity induced by pure tone exposure during the critical period in the primary auditory cortex. Elvax resin implants filled with either a blocking antibody against BDNF or the BDNF protein were placed on the A1 of rat pups throughout the critical period window. These pups were then exposed to 7 kHz pure tone for 7 consecutive days and their frequency representations were mapped. BDNF blockade completely prevented the shaping of cortical tuning by experience and resulted in poor overall frequency tuning in A1. By contrast, BDNF infusion on the developing A1 amplified the effect of 7 kHz tone exposure compared to control. These results indicate that BDNF signaling participates in the experience-dependent plasticity induced by pure tone exposure during the critical period in A1.

Manipulation of BDNF signaling modifies the experience-dependent plasticity induced by pure tone exposure during the critical period in the primary auditory cortex.

Directory of Open Access Journals (Sweden)

Renata Anomal

Full Text Available Sensory experience powerfully shapes cortical sensory representations during an early developmental "critical period" of plasticity. In the rat primary auditory cortex (A1, the experience-dependent plasticity is exemplified by significant, long-lasting distortions in frequency representation after mere exposure to repetitive frequencies during the second week of life. In the visual system, the normal unfolding of critical period plasticity is strongly dependent on the elaboration of brain-derived neurotrophic factor (BDNF, which promotes the establishment of inhibition. Here, we tested the hypothesis that BDNF signaling plays a role in the experience-dependent plasticity induced by pure tone exposure during the critical period in the primary auditory cortex. Elvax resin implants filled with either a blocking antibody against BDNF or the BDNF protein were placed on the A1 of rat pups throughout the critical period window. These pups were then exposed to 7 kHz pure tone for 7 consecutive days and their frequency representations were mapped. BDNF blockade completely prevented the shaping of cortical tuning by experience and resulted in poor overall frequency tuning in A1. By contrast, BDNF infusion on the developing A1 amplified the effect of 7 kHz tone exposure compared to control. These results indicate that BDNF signaling participates in the experience-dependent plasticity induced by pure tone exposure during the critical period in A1.

Analysis of mass incident diffusion in Weibo based on self-organization theory

Science.gov (United States)

Pan, Jun; Shen, Huizhang

2018-02-01

This study introduces some theories and methods of self-organization system to the research of the diffusion mechanism of mass incidents in Weibo (Chinese Twitter). Based on the analysis on massive Weibo data from Songjiang battery factory incident happened in 2013 and Jiiangsu Qidong OJI PAPER incident happened in 2012, we find out that diffusion system of mass incident in Weibo satisfies Power Law, Zipf's Law, 1/f noise and Self-similarity. It means this system is the self-organization criticality system and dissemination bursts can be understood as one kind of Self-organization behavior. As the consequence, self-organized criticality (SOC) theory can be used to explain the evolution of mass incident diffusion and people may come up with the right strategy to control such kind of diffusion if they can handle the key ingredients of Self-organization well. Such a study is of practical importance which can offer opportunities for policy makers to have good management on these events.

Evaluation of undergraduate clinical learning experiences in the subject of pediatric dentistry using critical incident technique.

Science.gov (United States)

Vyawahare, S; Banda, N R; Choubey, S; Parvekar, P; Barodiya, A; Dutta, S

2013-01-01

In pediatric dentistry, the experiences of dental students may help dental educators better prepare graduates to treat the children. Research suggests that student's perceptions should be considered in any discussion of their education, but there has been no systematic examination of India's undergraduate dental students learning experiences. This qualitative investigation aimed to gather and analyze information about experiences in pediatric dentistry from the students' viewpoint using critical incident technique (CIT). The sample group for this investigation came from all 240 3rd and 4th year dental students from all the four dental colleges in Indore. Using CIT, participants were asked to describe at least one positive and one negative experience in detail. They described 308 positive and 359 negative experiences related to the pediatric dentistry clinic. Analysis of the data resulted in the identification of four key factors related to their experiences: 1) The instructor; 2) the patient; 3) the learning process; and 4) the learning environment. The CIT is a useful data collection and analysis technique that provides rich, useful data and has many potential uses in dental education.

[Use of the critical incident technique in the development of a measurement tool for satisfaction in psychiatry].

Science.gov (United States)

Pourin, C; Daucourt, V; Barberger-Gateau, P

2001-06-01

Health care centers will have to set up a regular survey of their patients' satisfaction, in addition to the discharge questionnaire. Few instruments for measuring satisfaction are at present available. A working group associating 10 psychiatric hospitals in Aquitaine conducted a study on the specificity of this measure in psychiatry. To record the patient's perception on the stay in order to identify areas of satisfaction and dissatisfaction as perceived and reported by himself, using a qualitative approach. The critical incident technique was used in 3 volunteer hospitals, in patients hospitalised in psychiatric wards selected by their doctor. Interview using a semi-structured questionnaire were conducted by an investigator external to the departments. Data were analysed in a qualitative way. 32 interviews could be analysed, and 215 events were extracted. These events were classified in 12 themes. The events identified from these interviews have allowed identification of new areas of patient satisfaction, which could be used to build additional items centered on patients' preoccupations.

Critical Cases Faced by Mental Health Nurses and Assistant Nurses in Psychiatric Hospitals in Greece

Directory of Open Access Journals (Sweden)

Evmorfia Koukia

2013-01-01

Full Text Available Background: Psychiatric Nurses and nurses’ assistants working in an inpatient unit experience a significant number of critical cases. A small number of studies have explored which patients’ problems nurses perceive as ‘critical case or incident’ and particularly which interventions they choose. Aim: The aim of the research was 1. To identify the clinical problems that mental health nurses and assistant nurses characterize as critical 2. To report the main nursing interventions 3. To investigate the main person involved in the critical incident. Material-Method: Critical incident technique was used as a method of data collection. Content analysis was carried out in order nurses’ information to be categorized into subcategories. The sample consisted of 35 mental health nurses and nurses’ assistants who work in psychiatric acute inpatient wards.Results: Nurses identified ten types of critical incidents. They noted violence (verbal, physical by patients and psychotic symptoms to be the most critical situations. Nurses were the main person involved in these incidents. The study also described eight nursing interventions used by nurses when faced with critical events. Conclusions: The findings indicated that mental health nurses and assistant nurses working in acute inpatient wards are called to confront a variety of critical incidents in their every day practice. Further research is necessary to identify in-depth nursing interventions and decision-making used in these situations.

Pressure ulcer incidence and progression in critically ill subjects: influence of low air loss mattress versus a powered air pressure redistribution mattress.

Science.gov (United States)

Black, Joyce; Berke, Christine; Urzendowski, Gail

2012-01-01

The primary objective of this study was to compare facility-acquired pressure ulcer incidence and progression of pressure ulcers present on admission in critically ill patients, using 2 different support surfaces. We completed a comparison cohort study in a surgical intensive care unit (ICU). The study setting was a 12-bed cardiovascular ICU in a university-based hospital in the Midwestern United States. The sample comprised 52 critically ill patients; 31 were placed on low air loss weight-based pressure redistribution-microclimate management system beds and 21 were placed on integrated powered air pressure redistribution beds. Prior to the start of the study, 5 low airloss beds were placed in open rooms in the cardiovascular surgical ICU. Inclusion criteria were anticipated ICU stay of 3 days, and patients did not receive a speciality bed for pulmonary or wound issues. Initial assessment of the patients included risk assessment and prior events that would increase risk for pressure ulcer development such as extended time in operating room, along with skin assessment for existing pressure ulcers. Subjects in both groups had ongoing skin assessment every 3 to 4 days and a subjective evaluation of heel elevation and turning or repositioning by the researcher. Data were collected until the subjects were dismissed from the ICU. Patients admitted to the unit were assigned to open rooms following the usual protocols. The mean length of stay was 7.0 days, with an 8.1-day length of stay for subjects on "low air loss with microclimate management" beds (LAL-MCM) and 6.6 days on the integrated power pressure air redistribution (IP-AR) beds (P = NS). The incidence of pressure ulcers on the buttocks, sacrum, or coccyx was 0% (0/31) on the low air loss bed and 18% (4/21) on the IP-AR bed (P = .046). Five subjects had 6 pressure ulcers on admission. Two pressure ulcers on 2 patients worsened on the integrated power air redistribution beds, which required specialty bed rental

Quality of nursing care perceived by patients and their nurses: an application of the critical incident technique. Part 1.

Science.gov (United States)

Redfern, S; Norman, I

1999-07-01

The aims of the study were to identify indicators of quality of nursing care from the perceptions of patients and nurses, and to determine the congruence between patients' and nurses' perceptions. The paper is presented in two parts. Part 1 includes the background and methods to the study and the findings from the comparison of patients' and nurses' perceptions. Part 2 describes the perceptions of patients and nurses, and the conclusions drawn from the study as a whole. Patients and nurses in hospital wards were interviewed using the critical incident technique. We grouped 4546 indicators of high and low quality nursing care generated from the interview transcripts into 316 subcategories, 68 categories and 31 themes. Congruence between patients' and nurses' perceptions of quality was high and significant, although there was some difference of emphasis.

Dependence of the brittle ductile transition on strain-rate-dependent critical homologous temperature

Science.gov (United States)

Davis, Paul M.

2017-05-01

Earthquakes mainly occur in crust or mantle that is below a critical temperature for the tectonic strain-rate, \\dot{e}_t, such that stress builds up to the breaking point before it can relax due to creep. Then long-range stress correlation gives rise to power law seismicity including large events. The limiting temperature depends on pressure, which is taken into account by finding a critical homologous temperature THc = T/TM above which earthquakes are rarely observed (where T, TM are temperature and average melting temperature of constituent minerals). We find that THc for ocean plates is ∼0.55. For California earthquakes, it is also close to 0.55. The uppermost mantle layer of oceanic plates of thickness ∼50 km is composed of harzburgite and depleted peridotite from which basalt has been removed to form ocean crust. Thus it has a higher melting temperature than the peridotite of the surrounding mantle, or the lower halves of plates. Thicknesses of seismicity in deep subduction zones, determined from 2-D polynomial fits to a relocated catalogue, are ∼50 km, which suggests that the earthquake channel is confined to this layer. We construct models to find homologous temperatures in slabs, and find that seismicity thicknesses are also, on average, confined to TH ≤ 0.55 ± 0.05. The associated rheology is compared with that obtained from flexure models of ocean lithosphere. The brittle-ductile transition occurs where viscosity drops from high values in the cold cores of slabs to values of 1022-1023 Pa s, that is, where creep strain-rates become comparable to tectonic rates. The cut-off for deep earthquakes is not sharp. However they appear unlikely to occur if homologous temperature is high TH > 0.55. Exceptions to the rule are anomalously deep earthquakes such as those beneath the Iceland and the Hawaiian hotspots, and the Newport Inglewood Fault. These are smaller events with short-range stress correlation, and can be explained if strain-rates are two to

Safe Space Oddity: Revisiting Critical Pedagogy

Science.gov (United States)

Redmond, Melissa

2010-01-01

Inspired by an incident in a social work graduate classroom in which she was a teaching assistant, the author reflects on her commitment to constructivist teaching methods, critical theory, and critical pedagogy. Exploring the educational utility of notions such as public space and safe space, the author employs this personal experience to examine…

Validation of the Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition Recommendations for Caloric Provision to Critically Ill Obese Patients: A Pilot Study.

Science.gov (United States)

Mogensen, Kris M; Andrew, Benjamin Y; Corona, Jasmine C; Robinson, Malcolm K

2016-07-01

The Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN) recommend that obese, critically ill patients receive 11-14 kcal/kg/d using actual body weight (ABW) or 22-25 kcal/kg/d using ideal body weight (IBW), because feeding these patients 50%-70% maintenance needs while administering high protein may improve outcomes. It is unknown whether these equations achieve this target when validated against indirect calorimetry, perform equally across all degrees of obesity, or compare well with other equations. Measured resting energy expenditure (MREE) was determined in obese (body mass index [BMI] ≥30 kg/m(2)), critically ill patients. Resting energy expenditure was predicted (PREE) using several equations: 12.5 kcal/kg ABW (ASPEN-Actual BW), 23.5 kcal/kg IBW (ASPEN-Ideal BW), Harris-Benedict (adjusted-weight and 1.5 stress-factor), and Ireton-Jones for obesity. Correlation of PREE to 65% MREE, predictive accuracy, precision, bias, and large error incidence were calculated. All equations were significantly correlated with 65% MREE but had poor predictive accuracy, had excessive large error incidence, were imprecise, and were biased in the entire cohort (N = 31). In the obesity cohort (n = 20, BMI 30-50 kg/m(2)), ASPEN-Actual BW had acceptable predictive accuracy and large error incidence, was unbiased, and was nearly precise. In super obesity (n = 11, BMI >50 kg/m(2)), ASPEN-Ideal BW had acceptable predictive accuracy and large error incidence and was precise and unbiased. SCCM/ASPEN-recommended body weight equations are reasonable predictors of 65% MREE depending on the equation and degree of obesity. Assuming that feeding 65% MREE is appropriate, this study suggests that patients with a BMI 30-50 kg/m(2) should receive 11-14 kcal/kg/d using ABW and those with a BMI >50 kg/m(2) should receive 22-25 kcal/kg/d using IBW. © 2015 American Society for Parenteral and Enteral Nutrition.

The incidence of fever in US Critical Care Air Transport Team combat trauma patients evacuated from the theater between March 2009 and March 2010.

Science.gov (United States)

Minnick, Joanne M; Bebarta, Vikhyat S; Stanton, Marietta; Lairet, Julio R; King, James; Torres, Pedro; Aden, James; Ramirez, Rosemarie

2013-11-01

Most critically ill injured patients are transported out of the theater by Critical Care Air Transport Teams (CCATTs). Fever after trauma is correlated with surgical complications and infection. The purposes of this study are to identify the incidence of elevated temperature in patients managed in the CCATT environment and to describe the complications reported and the treatments used in these patients. We performed a retrospective review of available records of trauma patients from the combat theater between March 1, 2009, and March 31, 2010, who were transported by the US Air Force CCATT and had an incidence of hyperthermia. We then divided the cohort into 2 groups, patients transported with an elevation in temperature greater than 100.4°F and patients with no documented elevation in temperature. We used a standardized, secure electronic data collection form to abstract the outcomes. Descriptive data collected included injury type, temperature, use of a mechanical ventilator, cooling treatment modalities, antipyretics, intravenous fluid administration, and use of blood products. We also evaluated the incidence of complications during the transport in patients who had a recorded elevation in temperature greater than 100.4°F. A total of 248 trauma patients met the inclusion criteria, and 101 trauma patients (40%) had fever. The mean age was 28 years, and 98% of patients were men. The mechanism of injury was an explosion in 156 patients (63%), blunt injury in 11 (4%), and penetrating injury in 45 (18%), whereas other trauma-related injuries accounted for 36 patients (15%). Of the patients, 209 (84%) had battle-related injuries and 39 (16%) had non-battle-related injuries. Traumatic brain injury was found in 24 patients (24%) with an incidence of elevated temperature. The mean temperature was 101.6°F (range, 100.5°F-103.9°F). After evaluation of therapies and treatments, 80 trauma patients (51%) were intubated on a mechanical ventilator (P cooling interventions

Poster - 27: Incident Learning Practices in Ontario

Energy Technology Data Exchange (ETDEWEB)

Angers, Crystal; Medlam, Gaylene; Liszewski, Brian; Simniceanu, Carina [The Ottawa Hospital Cancer Centre, Mississauga Halton/Central West Regional Cancer Center, Odette Cancer Centre, Cancer Care Ontario (Canada)

2016-08-15

Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharing incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.

Poster - 27: Incident Learning Practices in Ontario

International Nuclear Information System (INIS)

Angers, Crystal; Medlam, Gaylene; Liszewski, Brian; Simniceanu, Carina

2016-01-01

Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharing incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.

Incidence and etiology of lumbar spondylolysis: review of the literature.

Science.gov (United States)

Sakai, Toshinori; Sairyo, Koichi; Suzue, Naoto; Kosaka, Hirofumi; Yasui, Natsuo

2010-05-01

Lumbar spondylolysis is a defect of the pars interarticularis known to occur as a stress fracture. Its incidence varies considerably depending on ethnicity, sex, and sports activity. However, there are few literature reviews describing its incidence in different ethnic groups or in people who engage in different sports. We reviewed the most relevant articles on spondylolysis published in scientific journals. First, we focused on its incidence in various ethnic groups distributed by sex, the familial occurrence, and in patients with relevant diseases. Second, we focused on the incidence of spondylolysis in relation to the sports practiced by the patients. Although placing special emphasis on the incidence of lumbar spondylolysis in the general population in Japan, we also reviewed the Japanese and English literature to investigate its incidence among those who engage in different sports. The incidence of lumbar spondylolysis in the general Japanese population was 5.9%. Most studies report that the incidence in higher in male subjects than in female subjects. We found that Japanese rugby and judo players were prone to suffer lumbar spondylolysis, at an incidence of about 20%. However, the incidence for Japanese professional soccer and baseball players was much higher, at 30%, which was more than five times the incidence in the general Japanese population. The incidence of lumbar spondylolysis varies depending on ethnicity, sex, family history, relevant disease, and sports activity.

Phylogeographic implications for release of critically endangered manatee calves rescued in Northeast Brazil

Science.gov (United States)

Luna, Fábia O.; Bonde, Robert K.; Attademo, Fernanda L.N.; Saunders, Jonathan W.; Meigs-Friend, Gaia; Passavante, José Zanon O.; Hunter, Margaret E.

2012-01-01

1. The Antillean manatee (Trichechus manatus manatus), a subspecies of the West Indian manatee, is a large-bodied marine mammal found in fresh, brackish, and marine habitats throughout the Caribbean Islands and Central and South America. Antillean manatees in Brazil are classified as critically endangered, with a census size of approximately 500 individuals. The population in the Northeast region of Brazil is suspected to have approximately 300 manatees and is threatened by habitat alteration and incidental entanglement in fishing gear. 2. A high incidence of dependent calf strandings have been identified near areas of altered critical manatee habitat. The majority of the calves are neonates, discovered alive, with no potential mothers nearby. These calves typically require human intervention to survive.

Are incident gallstones associated to sex-dependent changes with age? A cohort study

DEFF Research Database (Denmark)

Shabanzadeh, D M; Holmboe, S A; Sørensen, L T

2017-01-01

Age and female sex have repeatedly been identified as gallstone determinants but the underlying mechanisms are not clarified. The objectives of this study were to determine if changes with age in physiology, lifestyle, or reproductive hormones were associated with incident gallstones. A cohort...... pressure, blood lipids, self-rated health), lifestyle (smoking, alcohol and coffee consumption, dietary habits, physical activity level), and indices of reproductive function (number of births, oral contraceptive use, hormone replacement therapy, male reproductive hormones) were explored in females...... (OR) 0.94, 95% confidence interval (CI) [0.90; 0.98]) and the cessation of hormone replacement therapy (OR 0.29, 95% CI [0.10; 0.83]) inversely determined incident gallstones. In males, increasing levels of SHBG (OR 0.97, 95% CI [0.94; 0.998]) inversely determined incident gallstones. Other changes...

Factors precipitating the risk of aspiration in hospitalized patients: findings from a multicentre critical incident technique study.

Science.gov (United States)

Palese, Alvisa; Lesa, Lucia; Stroppolo, Giulia; Lupieri, Giulia; Tardivo, Stefano; Brusaferro, Silvio

2017-04-01

To elucidate factors, other than those clinical, precipitating the risk of aspiration in hospitalized patients. The Critical Incident Technique was adopted for this study in 2015. Three departments located in two academic hospitals in the northeast of Italy, equipped with 800 and 1500 beds, respectively. A purposeful sample of 12 registered nurses (RN), all of whom (i) had reported one or more episodes of aspiration during the longitudinal survey, (ii) had worked ≥3 years in the department, and (iii) were willing to participate, were included. Antecedent factors involved in episodes of aspiration as experienced by RNs were collected through an open-ended interview, and qualitatively analysed. In addition to clinical factors, other factors interacting with each other may precipitate the risk of aspiration episodes during hospitalization: at the nursing care level (misclassifying patients, transferring tasks to other healthcare professionals and standardizing processes to remove potential threats); at the family level (misclassifying patients, dealing with the cultural relevance of eating) and at the environmental level (positioning the patient, managing time pressures, distracting patient while eating, dealing with food consistency and irritating oral medication). At the hospital level, an adequate nursing workforce and models of care delivery, as well as time for initial and continuing patient and family assessment are required. At the unit level, patient-centred models of care aimed at reducing care standardization are also recommended; in addition, nursing, family and environmental factors should be recorded in the incident reports documenting episodes of aspiration. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Self-criticism, dependency, and stress reactivity: an experience sampling approach to testing Blatt and Zuroff's (1992) theory of personality predispositions to depression in high-risk youth.

Science.gov (United States)

Adams, Philippe; Abela, John R Z; Auerbach, Randy; Skitch, Steven

2009-11-01

S. J. Blatt and D. C. Zuroff's 1992 theory of personality predispositions to depression posits that individuals who possess high levels of self-criticism and/or dependency are vulnerable to developing depression following negative events. The current study used experience sampling methodology to test this theory in a sample of 49 children ages 7 to 14. Children completed measures of dependency, self-criticism, and depressive symptoms. Subsequently, children were given a handheld computer that signaled them to complete measures of depressive symptoms and negative events at randomly selected times over 2 months. Results of hierarchical linear modeling analyses indicated that higher levels of both self-criticism and dependency were associated with greater elevations in depressive symptoms following negative events. Furthermore, each personality predisposition remained a significant predictor of such elevations after controlling for the interaction between the other personality predisposition and negative events. The results suggest that dependency and self-criticism represent distinct vulnerability factors to depression in youth.

Determination of incident angle in radioisotope-excited EDXRF

Energy Technology Data Exchange (ETDEWEB)

Somogyi, A.; Pazsit, A. (Lajos Kossuth Univ., Debrecen (Hungary). Isotope Lab.)

Three different methods were used for the determination of the effective incident angle related to EDXRF when radioisotope annular sources are involved: weighted averaging, Compton peak method and minimization of the difference between the certificated and measured concentrations of six international standard samples. By measuring the Compton peak energies of various analytical reagent grade elements and compounds, it was found that the incoherent peak energy depends on the mean atomic number of the matrix, so the effective incident angle is also matrix dependent. (Author).

Determination of incident angle in radioisotope-excited EDXRF

International Nuclear Information System (INIS)

Somogyi, A.; Pazsit, A.

1993-01-01

Three different methods were used for the determination of the effective incident angle related to EDXRF when radioisotope annular sources are involved: weighted averaging, Compton peak method and minimization of the difference between the certificated and measured concentrations of six international standard samples. By measuring the Compton peak energies of various analytical reagent grade elements and compounds, it was found that the incoherent peak energy depends on the mean atomic number of the matrix, so the effective incident angle is also matrix dependent. (Author)

Angular dependence of the upper critical field in Bi sub 2 Sr sub 2 CuO sub 6 sub + subdelta

CERN Document Server

Vedeneev, S I

2002-01-01

The angular dependence of the upper critical field has been investigated in a wide range of temperatures in very high-quality Bi sub 2 Sr sub 2 CuO sub 6 sub + subdelta single crystals with critical temperature approx = 9 K in magnetic fields up to 28 T. Although the typical value of the normal state resistivity ratio approx = 10 sup 4 , the anisotropy ratio of the upper critical fields is much smaller. A model is proposed based on a strong anisotropy and a small transparency between superconducting layers

PREDICTIVE MODELS FOR SUPPORT OF INCIDENT MANAGEMENT PROCESS IN IT SERVICE MANAGEMENT

Directory of Open Access Journals (Sweden)

Martin SARNOVSKY

2018-03-01

Full Text Available ABSTRACT The work presented in this paper is focused on creating of predictive models that help in the process of incident resolution and implementation of IT infrastructure changes to increase the overall support of IT management. Our main objective was to build the predictive models using machine learning algorithms and CRISP-DM methodology. We used the incident and related changes database obtained from the IT environment of the Rabobank Group company, which contained information about the processing of the incidents during the incident management process. We decided to investigate the dependencies between the incident observation on particular infrastructure component and the actual source of the incident as well as the dependency between the incidents and related changes in the infrastructure. We used Random Forests and Gradient Boosting Machine classifiers in the process of identification of incident source as well as in the prediction of possible impact of the observed incident. Both types of models were tested on testing set and evaluated using defined metrics.

Dependability analysis of a safety critical system the LHC beam dumping system at CERN

CERN Document Server

Filippini, R

2006-01-01

This thesis presents the dependability study of the Beam Dumping System of the Large Hadron Collider (LHC), the high energy particle accelerator to be commissioned at CERN in summer 2007. There are two identical, independent LHC Beam Dumping Systems (LBDS), one per LHC beam, each consisting of a series of magnets that extract the particle beam from the LHC ring into the extraction line leading to the absorbing block. The consequences of a failure within the LBDS can be very severe. This risk is reduced by applying redundancy to the design of the most critical components and on-line surveillance that, in case of a detected failure, issues a safe operation abort, called false beam dump. The system has been studied applying Failure Modes Effects and Criticality Analysis (FMECA) and reliability prediction. The system failure processes have been represented with a state transition diagram, governed by a Markov regenerative stochastic process, and analysed for different operational scenarios for one year of operati...

Evaluation of undergraduate clinical learning experiences in the subject of pediatric dentistry using critical incident technique

Directory of Open Access Journals (Sweden)

S Vyawahare

2013-01-01

Full Text Available Introduction: In pediatric dentistry, the experiences of dental students may help dental educators better prepare graduates to treat the children. Research suggests that student′s perceptions should be considered in any discussion of their education, but there has been no systematic examination of India′s undergraduate dental students learning experiences. Aim: This qualitative investigation aimed to gather and analyze information about experiences in pediatric dentistry from the students′ viewpoint using critical incident technique (CIT. Study Design: The sample group for this investigation came from all 240 3 rd and 4 th year dental students from all the four dental colleges in Indore. Using CIT, participants were asked to describe at least one positive and one negative experience in detail. Results: They described 308 positive and 359 negative experiences related to the pediatric dentistry clinic. Analysis of the data resulted in the identification of four key factors related to their experiences: 1 The instructor; 2 the patient; 3 the learning process; and 4 the learning environment. Conclusion: The CIT is a useful data collection and analysis technique that provides rich, useful data and has many potential uses in dental education.

Workplace Disruption following Psychological Trauma: Influence of Incident Severity Level on Organizations' Post-Incident Response Planning and Execution

Directory of Open Access Journals (Sweden)

GS DeFraia

2016-04-01

Full Text Available Background: Psychologically traumatic workplace events (known as critical incidents, which occur globally, are increasing in prevalence within the USA. Assisting employers in their response is a growing practice area for occupational medicine, occupational social work, industrial psychology and other occupational health professions. Traumatic workplace events vary greatly in their level of organizational disruption. Objective: To explore whether extent of workplace disruption influences organizations' decisions for post-incident response planning and plan execution. Methods: Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring extent of workplace disruption associated with organizational decisions regarding post-incident response. Results: The more severe and disruptive the incident, the more likely organizations planned for and followed through to deliver on-site interventions. Following more severe incidents, organizations were also more likely to deliver group sessions and to complete follow-up consultations to ensure ongoing worker recovery. Conclusion: Increasing occupational health practitioners' knowledge of varying levels of organizational disruption and familiarity with a range of organizational response strategies improves incident assessment, consultation and planning, and ensures interventions delivered are consistent with the level of assistance needed on both worker and organizational levels.

Workplace Disruption following Psychological Trauma: Influence of Incident Severity Level on Organizations' Post-Incident Response Planning and Execution.

Science.gov (United States)

DeFraia, G S

2016-04-01

Psychologically traumatic workplace events (known as critical incidents), which occur globally, are increasing in prevalence within the USA. Assisting employers in their response is a growing practice area for occupational medicine, occupational social work, industrial psychology and other occupational health professions. Traumatic workplace events vary greatly in their level of organizational disruption. To explore whether extent of workplace disruption influences organizations' decisions for post-incident response planning and plan execution. Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring extent of workplace disruption associated with organizational decisions regarding post-incident response. The more severe and disruptive the incident, the more likely organizations planned for and followed through to deliver on-site interventions. Following more severe incidents, organizations were also more likely to deliver group sessions and to complete follow-up consultations to ensure ongoing worker recovery. Increasing occupational health practitioners' knowledge of varying levels of organizational disruption and familiarity with a range of organizational response strategies improves incident assessment, consultation and planning, and ensures interventions delivered are consistent with the level of assistance needed on both worker and organizational levels.

Ethnic density of neighborhoods and incidence of psychotic disorders among immigrants

NARCIS (Netherlands)

Veling, Wim; Susser, Ezra; van Os, Jim; Mackenbach, Johan P; Selten, Jean-Paul; Hoek, Hans W

OBJECTIVE: A high incidence of psychotic disorders has been reported in immigrant ethnic groups in Western Europe. Some studies suggest that ethnic density may influence the incidence of schizophrenia. The authors investigated whether this increased incidence among immigrants depends on the ethnic

Pharmacy student decision making in over-the-counter medicine supply: A critical incident study.

Science.gov (United States)

McMillan, Sara S; Thangarajah, Thachaayini; Anderson, Claire; Kelly, Fiona

2017-09-28

Various factors influence decision making in over-the-counter (OTC) medicine consultations, yet limited studies have focused, in-depth, on the thought process of pharmacy staff. This includes pharmacy students as pharmacists-in-training. To explore the factors that influence pharmacy students' decisions in relation to OTC consultations and choice of OTC medicine/s. Semi-structured interviews using the critical incident technique were undertaken with ten pharmacy students in Australia, who also worked as part-time pharmacy staff. Nine key themes were identified to influence pharmacy student decision making in OTC consultations, including customer response, confidence and scope of practice. Product requests were reported as more challenging due to customer expectations and experiences in other pharmacies, states or countries. Although negative customer response influenced some students to supply medicines in contradiction of evidence, an overarching concern for safety meant that a medicine was only supplied if unlikely to cause harm. Students reported developing confidence in OTC decision making more from real-life practice than university training; greater confidence was identified for inquiries more frequently experienced in the pharmacy. Students perceived that customers had assumptions around support staff, and were happier to talk to students than assistants. This study further identified that OTC decision making is a complex process for pharmacy students. Additional opportunities for experiential learning within this area are suggested, such as work-based placements or in-class activities such as role-plays with simulated patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Congenital Hypothyroidism: Increased Incidence in Yazd Province, Iran

Directory of Open Access Journals (Sweden)

M. Noori-Shadkam

2012-07-01

Full Text Available Introduction: Congenital hypothyroidism (CH is one of the most common preventable causes of mental retardation. Its worldwide incidence is estimated to be one in 2500-5500 births. Assessment of thyroid gland in neonates is critical. The aims of this study were to demonstrate the incidence of CH in neonates born in Yazd province, Iran in 1389 (2010 and compare the results with other reported studies and investigate biochemical characteristics of affected infants. Materials & Methods: This is an analytical descriptive cross-sectional study. The study was conducted on all infants (13022 births born in 1389 (March 2010-March 2011. Thyroid stimulating hormone (TSH was measured using ELISA technique. Results: Forty five infants suffered from congenital hypothyroidism with an overall incidence of one in 289 live births. Twenty five of the diagnosed infants were males (incidence 1:261 and twenty were females (incidence 1:325. The incidence of CH in boys was more than girls (P-value = 0.295. The highest incidence of CH was observed in spring followed by summer and the lowest incidence was in autumn followed by winter (P-value=0.000. Conclusion: The CH incidence was 10.3 to 13.8 times more than other countries. The highest CH incidence was in spring followed by summer and the lowest incidence was in autumn followed by winter. It is important that a larger size of cases need to be screened and more information on the aetiology of the affected infants to be obtained

Guiding of slow Ne7+ ions through nanocapillaries in insulating polyethylene terephthalate: Incident current dependence

International Nuclear Information System (INIS)

Stolterfoht, N.; Hellhammer, R.; Bundesmann, J.; Fink, D.; Kanai, Y.; Kambara, T.; Ikeda, T.; Hoshino, M.; Yamazaki, Y.

2007-01-01

The transmission of highly charged ions through nanocapillaries in insulating polyethylene terephthalate (PET) polymers was investigated. In experiments at laboratories in RIKEN (Japan) and HMI (Germany) different detection methods were applied to study the ion current dependence in a wide range covering two orders of magnitude. At HMI an electrostatic ion spectrometer was used and at RIKEN a two-dimensional position sensitive detector was implemented. New PET samples with parallel capillaries and low density were manufactured. For tilted capillaries, the ions are guided along the capillary axis, since the majority of ions are deflected in a charge patch created in the capillary entrance. The results provide insights into the mechanisms of capillary guiding. The fraction of transmitted ions was found to be nearly independent on the incident ion current indicating a sudden increase in the discharge current depleting the entrance charge patch. The experimental results were well-reproduced by model calculations based on a nonlinear (exponential) expression for the discharge current

Study of critical dependence of stable phases in Nitinol on heat treatment using electrical resistivity probe

International Nuclear Information System (INIS)

Uchil, J.; Mohanchandra, K.P.; Kumara, K.G.; Mahesh, K.K.

1998-01-01

Phase transformations in 40% cold-worked Nitinol as a function of heat treatment have been studied using electrical resistivity variation with temperature. The stabilisation of austenitic, rhombohedral and martensitic phases is shown to critically depend on the temperatures of heat treatment by the analysis of temperature dependence of electrical resistivity in heating and cooling parts of the cycle. Characteristic values of electrical resistivity of the stable phases are determined. The R-phase has been found to form continuously with increasing heat-treatment temperature starting from room temperature and to suddenly disappear beyond heat-treatment at 683 K. The observed presence or absence of R-phase is confirmed by heat capacity measurements as a function of temperature. (orig.)

Martin Marietta Energy Systems Nuclear Criticality Safety Improvement Program

International Nuclear Information System (INIS)

Speas, I.G.

1987-01-01

This report addresses questions raised by criticality safety violation at several DOE plants. Two charts are included that define the severity and reporting requirements for the six levels of accidents. A summary is given of all reported criticality incident at the DOE plants involved. The report concludes with Martin Marietta's Nuclear Criticality Safety Policy Statement

Incidence of constipation in an intensive care unit.

Science.gov (United States)

Guerra, Tatiana Lopes de Souza; Mendonça, Simone Sotero; Marshall, Norma Guimarães

2013-01-01

To evaluate the incidence of constipation in critical patients on enteral nutrition in a hospital intensive care unit and to correlate this incidence with the variables found for critical patients. The present investigation was a retrospective analytical study conducted in the intensive care unit of Hospital Regional da Asa Norte (DF) via the analysis of medical records of patients admitted during the period from January to December 2011. Data on the incidence of constipation and enteral nutritional support, gastrointestinal changes, stool frequency, ventilatory support, and outcomes were collected and analyzed. The initial sample consisted of 127 patients admitted to the unit during the period from January to December 2011. Eighty-four patients were excluded, and the final sample consisted of 43 patients. The incidence of constipation, defined as no bowel movement during the first 4 days of hospitalization, was 72% (n=31). The patients were divided into a control group and a constipated group. The group of constipated patients reached the caloric target, on average, at 6.5 days, and the control group reached the caloric target in 5.6 days (p=0.51). Constipation was not associated with the length of hospital stay, suspension of nutritional support, or outcome of hospitalization. There was an association between evacuation during hospitalization and a longer duration of hospitalization for a subgroup of patients who did not evacuate during the entire period (p=0.009). The incidence of constipation in the unit studied was 72%. Only the absence of evacuation during hospitalization was associated with longer hospital stays. Constipation was not associated with the length of hospital stay, suspension of nutritional support, or outcome of hospitalization.

Energy dependence of ion-induced sputtering yields from monoatomic solids at normal incidence

International Nuclear Information System (INIS)

Yamamura, Yasunori; Tawara, Hiro.

1995-03-01

The yields of the ion-induced sputtering from monoatomic solids at normal incidence for various ion-target combinations are presented graphically as a function of the incident ion energy. In order to fill the lack of the experimental data, the sputtering yields are also calculated by the Monte Carlo simulation code ACAT for some ion-target combinations. Each graph shows available experimental data points and the ACAT data, together with the sputtering yields calculated by the present empirical formula, whose parameters are determined by the best-fit to available data. (author)

Critical care admission of South African (SA surgical patients: Results of the SA Surgical Outcomes Study

Directory of Open Access Journals (Sweden)

David Lee Skinner

2017-05-01

Full Text Available Background. Appropriate critical care admissions are an important component of surgical care. However, there are few data describing postoperative critical care admission in resource-limited low- and middle-income countries. Objective. To describe the demographics, organ failures, organ support and outcomes of non-cardiac surgical patients admitted to critical care units in South Africa (SA. Methods. The SA Surgical Outcomes Study (SASOS was a 7-day national, multicentre, prospective, observational cohort study of all patients ≥16 years of age undergoing inpatient non-cardiac surgery between 19 and 26 May 2014 at 50 government-funded hospitals. All patients admitted to critical care units during this study were included for analysis. Results. Of the 3 927 SASOS patients, 255 (6.5% were admitted to critical care units; of these admissions, 144 (56.5% were planned, and 111 (43.5% unplanned. The incidence of confirmed or strongly suspected infection at the time of admission was 35.4%, with a significantly higher incidence in unplanned admissions (49.1 v. 24.8%, p<0.001. Unplanned admission cases were more frequently hypovolaemic, had septic shock, and required significantly more inotropic, ventilatory and renal support in the first 48 hours after admission. Overall mortality was 22.4%, with unplanned admissions having a significantly longer critical care length of stay and overall mortality (33.3 v. 13.9%, p<0.001. Conclusion. The outcome of patients admitted to public sector critical care units in SA is strongly associated with unplanned admissions. Adequate ‘high care-dependency units’ for postoperative care of elective surgical patients could potentially decrease the burden on critical care resources in SA by 23%. This study was registered on ClinicalTrials.gov (NCT02141867.

Effect of colored noise on the critical dynamics of the Time-Dependent Landau-Ginzburg Model A

International Nuclear Information System (INIS)

Korutcheva, E.; Rubia, J. de la

1999-08-01

By using the dynamical renormalization-group method, we show that the introduction of an additive colored noise with weak long-range correlations in the Time-Dependent Landau-Ginzburg Model A, does not give perturbative corrections for the dynamical critical exponent at least up to order O(ε 2 ). This result differs for a system with random quenched impurities, where a similar type of impurity correlation leads to corrections even of order O(ε). (author)

Quality of the Critical Incident Technique in practice: Interrater reliability and users' acceptance under real conditions

Directory of Open Access Journals (Sweden)

ANNA KOCH

2009-03-01

Full Text Available The Critical Incident Technique (CIT is a widely used task analysis method in personnel psychology. While studies on psychometric properties of the CIT so far primarily took into account relevance ratings of task-lists or attributes, and hence, only a smaller or adapted part of the CIT, little is known about the psychometric properties of the complete CIT in its most meaningful and fruitful way. Therefore, the aim of the present study was to assess interrater reliability and the participants’ view of the CIT under real conditions and especially to provide data for the key step of the CIT: the classification of behavior descriptions into requirements. Additionally, the cost-benefit-ratio and practicability were rated from the participants’ views as an important indicator for the acceptance of the task analysis approach in practice. Instructors of German Institutions for Statutory Accidents Insurance and Prevention as well as their supervisors took part in a job analysis with the CIT. Moderate interrater reliability for the relevance rating was found while the classification step yielded unexpectedly low coefficients for interrater reliability. The cost-benefit-ratio and practicability of the complete CIT were rated very positive. The results are discussed in relation to determinants that facilitate or impede the application of task analysis procedures.

Experienced dilemmas of everyday life in chronic neuropathic pain patients--results from a critical incident study.

Science.gov (United States)

Hensing, Gunnel K E; Sverker, Annette M; Leijon, Göran S

2007-06-01

Neuropathic pain is a disabling chronic condition with limited therapeutic options. Few studies have addressed patient's experience and strategies. The aim of this study was to explore dilemmas experienced in order to improve care and rehabilitation. An interview study with 39 patients suffering from neuropathic pain of different origin was performed. We used the critical incident technique to collect data. Questions on occasions when patients had been hindered by or reminded of their neuropathic pain were included, and the self-perceived consequences and management of such occasions. The interviews were transcribed verbatim and analysed qualitatively. A broad range of experiences categorised into dilemmas, disturbances, consequences and managements from most parts of everyday life was identified. The dilemmas were 'housework', 'sitting', 'physical activity', 'personal hygiene', 'sleeping difficulties', 'hypersensitivity to external stimuli', 'social relationships', 'transportation' and 'leisure time'. Disturbances were 'failures', 'inabilities' and 'restrictions'. Consequences were 'increased pain', 'psychological reactions' and 'physical symptoms'. The majority of the patients used activity-oriented strategies to manage their pain such as alternative ways of performing the task, a cognitive approach or simply ignoring the pain. This is one of the first studies presenting detailed data on everyday dilemmas, disturbances and consequences of patients with chronic neuropathic pain. Such information is important in clinical settings to improve care and rehabilitation.

Communicating the Improvements Developed from Critical Incident Reports is an Essential Part of CIRS.

Science.gov (United States)

Hubertus, J; Piehlmeier, W; Heinrich, M

2016-09-01

The Critical Incident Reporting System (CIRS) is a tool for employees to report anonymously of near misses. Its efficiency and improvement of safety is proved by many studies. Our department introduced CIRS in 2009 and it is used frequently. As the number of reports decreased over time we asked for factors responsible for the reduced use. All employees had access to CIRS and have been trained in several courses of instruction. Accomplished results and consequences were published in biannual newsletters. In 2014 we initiated an anonymous employee attitude survey to ask for their experience and satisfaction with CIRS. 88 near misses were reported since 2009. 44 (50%) reports were classified as RS1, 34 (38.6%) as RS2, and 10 (11.4%) as RS3. No RS4 reports were notified. Most reports concerned problems with administration of medication (n=26; 29.5%) and problems with technical devices (n=18; 20.5%). 75 (83%) of our employees participated in the survey. 64 (86.5%) discerned that CIRS is anonymous. 31 (41.9%) reported already a near miss. Of note, two-third didn't realize an improvement following their report. On the other hand, only half of the pollees stated to read the newsletter. Even if efficiency and advantages of CIRS are proved and undeniable, sufficient and perpetual feedback of results and improvements developed by the CIRS team and regular trainings of the employees are mandatory for the success of CIRS. © Georg Thieme Verlag KG Stuttgart · New York.

Secondary emission coefficient dependence on the angle of incidence of primary electrons on CsI and LiF layers. [0. 9 to 3 keV, mechanism

Energy Technology Data Exchange (ETDEWEB)

Shabel' nikova, A E; Yasnopol' skii, N L

1976-08-01

The angular dependence was studied of the secondary emission coefficient sigma for CsI and LiF dielectrics which have large sigma in conditions of normal incidence of primary electrons. Measurements were taken down to the angle of 85 deg for energies of primary electrons between 0.9 and 3 keV. In the whole range of angles a nonmonotonic angular dependence sigma is observed. The dependence shows itself particularly clearly for CsI at large energies of primary electrons. Such a behaviour is due to the decrease in the depth of yield of inelastically reflected electrons and to the increase in the inelastic reflection coefficient of the substance.

Nuclear multifragmentation critical exponents

International Nuclear Information System (INIS)

Bauer, W.; Friedman, W.A.; Univ. of Wisconsin, Madison, WI

1995-01-01

In a recent Letter, cited in a reference, the EoS collaboration presented data of fragmentation of 1 A GeV gold nuclei incident on carbon. By analyzing moments of the fragment charge distribution, the authors claim to determine the values of the critical exponents γ, β, and τ for finite nuclei. These data represent a crucial step forward in the understanding of the physics of nuclear fragmentation. However, as shown in this paper, the analysis presented in the cited reference is not sufficient to support the claim that the critical exponents for nuclear fragmentation have been unambiguously determined

Malnutrition in the critically ill child: the importance of enteral nutrition.

Science.gov (United States)

Prieto, Marta Botrán; Cid, Jesús López-Herce

2011-11-01

Malnutrition affects 50% of hospitalized children and 25-70% of the critically ill children. It increases the incidence of complications and mortality. Malnutrition is associated with an altered metabolism of certain substrates, increased metabolism and catabolism depending on the severity of the lesion, and reduced nutrient delivery. The objective should be to administer individualized nutrition to the critically ill child and to be able to adjust the nutrition continuously according to the metabolic changes and evolving nutritional status. It would appear reasonable to start enteral nutrition within the first 24 to 48 hours after admission, when oral feeding is not possible. Parenteral nutrition should only be used when enteral nutrition is contraindicated or is not tolerated. Energy delivery must be individually adjusted to energy expenditure (40-65 kcal/100 calories metabolized/day) with a protein delivery of 2.5-3 g/kg/day. Frequent monitoring of nutritional and metabolic parameters should be performed.

Assessing dependability and resilience in critical infrastructures: challenges and opportunities

NARCIS (Netherlands)

Avritzer, Alberto; Di Giandomenico, Felicita; Remke, Anne Katharina Ingrid; Riedl, Martin; Wolter, Katinka; Avritzer, Alberto; Vieira, Marco; van Moorsel, Aad

2012-01-01

Critical infrastructures (CI) are very complex and highly interdependent systems, networks and assets that provide essential services in our daily life. Most CI are either built upon or monitored and controlled by vulnerable information and communication technology (ICT) systems. Critical

Analysis of dependent failures in the ORNL precursor study

International Nuclear Information System (INIS)

Ballard, G.M.

1985-01-01

The study of dependent failures (or common cause/mode failures) in the safety assessment of potentially hazardous plant is one of the significant areas of uncertainty in performing probabilistic safety studies. One major reason for this uncertainty is that data on dependent failures is apparently not readily available in sufficient quantity to assist in the development and validation of models. The incident reports that were compiled for the ORNL study on Precursors to Severe Core Damage Accidents (NUREG/CR-2497) provide an opportunity to look at the importance of dependent failures in the most significant incidents of recent reactor operations, to look at the success of probabilistic risk assessment (PRA) methods in accounting for the contribution of dependent failures, and to look at the dependent failure incidents with the aim of identifying the most significant problem areas. In this paper an analysis has been made of the incidents compiled in NUREG/CR-2497 and events involving multiple failures which were not independent have been identified. From this analysis it is clear that dependent failures are a very significant contributor to the precursor incidents. The method of enumeration of accident frequency used in NUREG-2497 can be shown to take account of dependent failures and this may be a significant factor contributing to the apparent difference between the precursor accident frequency and typical PRA frequencies

Incidence of Postoperative Residual Paralysis in a Nigerian ...

African Journals Online (AJOL)

2018-01-30

Jan 30, 2018 ... Aim: The aim of this study was to determine the incidence of PORP, associated factors related with its occurrence and critical respiratory events in the postanesthesia recovery room (PAR) at our institution. Methodology: Forty‑one adult patients were scheduled for elective surgeries requiring GA with the use ...

Incident reporting to BfArM - regulatory framework, results and challenges.

Science.gov (United States)

Seidel, Robin; Stößlein, Ekkehard; Lauer, Wolfgang

2016-04-01

Medical devices are manifold and one of the most innovative fields of technology. As technologies advance, former limits cease to exist and complex devices become reality. Medical devices represent a very dynamic field with high economic relevance. The manufacturer of a medical device is obliged to minimize product-related risks as well as to demonstrate compliance with the so-called "essential requirements" regarding safety and performance before placing the device on the market. Any critical incident in relation to the application of a medical device has to be reported to the competent authority for risk assessment, which in Germany is either the Federal Institute for Drugs and Medical Devices (BfArM) or the Paul Ehrlich Institute (PEI) depending on the type of device. In this article, the German regulatory framework for medical devices and the resulting tasks for BfArM are described as well as the topics of its recently installed research and development group on prospective risk identification and application safety for medical devices. Results of failure mode and root cause analyses of incident data are presented as well as further data on cases with the result "root-cause analysis not possible". Finally an outlook is given on future challenges regarding risk assessment for medical devices.

Dependence of Parameters of Laser-Produced Au Plasmas on the Incident Laser Energy of Sub-Nanosecond and Picosecond Laser Pulses

International Nuclear Information System (INIS)

Woryna, E.; Badziak, J.; Makowski, J.; Parys, P.; Vankov, A.B.; Wolowski, J.; Krasa, J.; Laska, L.; Rohlena, K.

2001-01-01

The parameters of Au plasma as functions of laser energy for ps pulses are presented and compared with the ones for sub-ns pulses at nearly the same densities of laser energy. The experiments were performed at the IPPLM with the use of CPA (chirped pulse amplification) Nd:glass laser system. Thick Au foil targets were irradiated by normally incident focused laser beams with maximum intensities of 8x10 16 and 2x10 14 W/cm 2 for ps and sub-ns laser pulses, respectively. The characteristics of ion streams were investigated with the use of ion diagnostics methods based on the time-of flight technique. In these experiments the laser energies were changed in the range from 90 to 700 mJ and the measurements were performed at a given focus position FP = 0 and along the target normal for both the laser pulses. The charge carried by the ions, the maximum ion velocities of fast and thermal ion groups, the maximum ion current density as well as the area of photopeak in dependence on the incident laser energy for sub-ns and ps pulses were investigated and discussed. (author)

Widening the scope of incident analysis in complex work environments

NARCIS (Netherlands)

Vuuren, van W.; Kanse, L.; Manser, T.

2003-01-01

Incident analysis is commonly used as a tooi to provide information on how to improve health and safety in complex work environments. The effectiveness of this tooi, however, depends on how the analysis is actually carried out. The traditional view on incident analysis highlights the role of human

Visualizing common operating picture of critical infrastructure

Science.gov (United States)

Rummukainen, Lauri; Oksama, Lauri; Timonen, Jussi; Vankka, Jouko

2014-05-01

This paper presents a solution for visualizing the common operating picture (COP) of the critical infrastructure (CI). The purpose is to improve the situational awareness (SA) of the strategic-level actor and the source system operator in order to support decision making. The information is obtained through the Situational Awareness of Critical Infrastructure and Networks (SACIN) framework. The system consists of an agent-based solution for gathering, storing, and analyzing the information, and a user interface (UI) is presented in this paper. The UI consists of multiple views visualizing information from the CI in different ways. Different CI actors are categorized in 11 separate sectors, and events are used to present meaningful incidents. Past and current states, together with geographical distribution and logical dependencies, are presented to the user. The current states are visualized as segmented circles to represent event categories. Geographical distribution of assets is displayed with a well-known map tool. Logical dependencies are presented in a simple directed graph, and users also have a timeline to review past events. The objective of the UI is to provide an easily understandable overview of the CI status. Therefore, testing methods, such as a walkthrough, an informal walkthrough, and the Situation Awareness Global Assessment Technique (SAGAT), were used in the evaluation of the UI. Results showed that users were able to obtain an understanding of the current state of CI, and the usability of the UI was rated as good. In particular, the designated display for the CI overview and the timeline were found to be efficient.

Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy.

Science.gov (United States)

Lim, Woo Hyeon; Park, Chang Min; Yoon, Soon Ho; Lim, Hyun-Ju; Hwang, Eui Jin; Lee, Jong Hyuk; Goo, Jin Mo

2018-03-01

To evaluate the time-dependent incidence, risk factors and clinical significance of percutaneous lung biopsy (PLB)-related pneumothorax. From January 2012-November 2015, 3,251 patients underwent 3,354 cone-beam CT-guided PLBs for lung lesions. Cox, logistic and linear regression analyses were performed to identify time-dependent risk factors of PLB-related pneumothorax, risk factors of drainage catheter insertion and those of prolonged catheter placement, respectively. Pneumothorax occurred in 915/3,354 PLBs (27.3 %), with 230/915 (25.1 %) occurring during follow-ups. Risk factors for earlier occurrence of PLB-related pneumothorax include emphysema (HR=1.624), smaller target (HR=0.922), deeper location (HR=1.175) and longer puncture time (HR=1.036), while haemoptysis (HR=0.503) showed a protective effect against earlier development of pneumothorax. Seventy-five cases (8.2 %) underwent chest catheter placement. Mean duration of catheter placement was 3.2±2.0 days. Emphysema (odds ratio [OR]=2.400) and longer puncture time (OR=1.053) were assessed as significant risk factors for catheter insertion, and older age (parameter estimate=1.014) was a predictive factor for prolonged catheter placement. PLB-related pneumothorax occurred in 27.3 %, of which 25.1 % developed during follow-ups. Smaller target size, emphysema, deeply-located lesions were significant risk factors of PLB-related pneumothorax. Emphysema and older age were related to drainage catheter insertion and prolonged catheter placement, respectively. • One-fourth of percutaneous lung biopsy (PLB)-related pneumothorax occurs during follow-up. • Smaller, deeply-located target and emphysema lead to early occurrence of pneumothorax. • Emphysema is related to drainage catheter insertion for PLB-related pneumothorax. • Older age may lead to prolonged catheter placement for PLB-related pneumothorax. • Tailored management can be possible with time-dependent information of PLB-related pneumothorax.

Starting on haemodialysis: a qualitative study to explore the experience and needs of incident patients.

Science.gov (United States)

Lai, Alden Yuanhong; Loh, Angela Ping Ping; Mooppil, Nandakumar; Krishnan, Deby Sarojiuy Pala; Griva, Konstadina

2012-01-01

Dialysis can be very stressful with the initial months onto treatment being highly critical in terms of both adaptation and mortality. This qualitative study aimed to explore the lived experiences of incident haemodialysis patients in Singapore. Topics related to the end-stage renal disease diagnosis and haemodialysis treatment were raised with 13 incident haemodialysis patients in the form of semi-structured interviews, and interpretative phenomenological analysis was undertaken as the framework for data analysis. Emotional distress, treatment-related concerns and social support emerged as main issues following a critical review of themes. Our study revealed that incident haemodialysis patients have emotional and informational needs, highlighting the importance of intervention programmes in particular to this patient group to promote better psychosocial adjustment to the disease and its treatment.

Lesão renal aguda em crianças: incidência e fatores prognósticos em pacientes gravemente enfermos Acute kidney injury in children: incidence and prognostic factors in critical ill patients

Directory of Open Access Journals (Sweden)

Kenia Machado Souza Freire

2010-06-01

revertible renal function impairment involving inability to maintain homeostasis. In pediatrics, the main causes of acute kidney injury are sepsis, use of nephrotoxic drugs and renal ischemia in critically ill patients. The incidence of acute kidney injury in these patients ranges from 20 to 30%, resulting in increased morbid-mortality, a 40 to 90% rate. This study aimed to evaluate the incidence of acute kidney injury in intensive care unit patients, to categorize the severity of the acute kidney injury according to the Pediatric Risk, Injury, Failure, Loss, End-Stage (pRIFLE, examine the relationship between the acute kidney injury and severity using the Pediatric Index of Mortality (PIM and to analyze outcome predictors. METHODS: A prospective study of the patients admitted to the intensive care unit of Hospital Infantil Joana de Gusmão - Florianópolis / SC - Brazil was conducted between July 2008 and January 2009. Were evaluated daily the urine output and serum creatinine, and the patients were categorized according to the pRIFLE criteria. RESULTS: During the follow-up period, 235 children were admitted. The incidence of acute kidney injury was 30.6%, and the maximal pRIFLE score during hospitalization was 12.1% for R, 12.1% for I and 6.4% for F. The mortality rate was 12.3%. The patients who developed acute kidney injury had a ten times bigger risk of death versus the not exposed patients. CONCLUSIONS: Acute kidney injury is frequent in critically ill patients. Early diagnosis and prompt and appropriate therapy for each clinical aspect may change this condition's course and severity, and reduce the patients' morbidity and mortality.

Book Review: Critical Condition: Replacing Critical Thinking with Creativity by Patrick Finn

OpenAIRE

Matthews, Jodie

2016-01-01

In Critical Condition: Replacing Critical Thinking with Creativity, Patrick Finn expands upon his 2011 TEDx Talk, ‘Loving Communication’, to suggest that critical thinking implies disapproval and unnecessary judgement originating from a particular mode of Classical thought. Jodie Matthews argues that Finn’s discussion is dependent upon a crudely drawn straw man and neglects to consider thinking critically as a necessary corollary, rather than antithesis, to thinking creatively.

Identifying medication error chains from critical incident reports: a new analytic approach.

Science.gov (United States)

Huckels-Baumgart, Saskia; Manser, Tanja

2014-10-01

Research into the distribution of medication errors usually focuses on isolated stages within the medication use process. Our study aimed to provide a novel process-oriented approach to medication incident analysis focusing on medication error chains. Our study was conducted across a 900-bed teaching hospital in Switzerland. All reported 1,591 medication errors 2009-2012 were categorized using the Medication Error Index NCC MERP and the WHO Classification for Patient Safety Methodology. In order to identify medication error chains, each reported medication incident was allocated to the relevant stage of the hospital medication use process. Only 25.8% of the reported medication errors were detected before they propagated through the medication use process. The majority of medication errors (74.2%) formed an error chain encompassing two or more stages. The most frequent error chain comprised preparation up to and including medication administration (45.2%). "Non-consideration of documentation/prescribing" during the drug preparation was the most frequent contributor for "wrong dose" during the administration of medication. Medication error chains provide important insights for detecting and stopping medication errors before they reach the patient. Existing and new safety barriers need to be extended to interrupt error chains and to improve patient safety. © 2014, The American College of Clinical Pharmacology.

Influence of crack opening and incident wave angle on second harmonic generation of Lamb waves

Science.gov (United States)

Yang, Yi; Ng, Ching-Tai; Kotousov, Andrei

2018-05-01

Techniques utilising second harmonic generation (SHG) have proven their great potential in detecting contact-type damage. However, the gap between the practical applications and laboratory studies is still quite large. The current work is aimed to bridge this gap by investigating the effects of the applied load and incident wave angle on the detectability of fatigue cracks at various lengths. Both effects are critical for practical implementations of these techniques. The present experimental study supported by three-dimensional (3D) finite element (FE) modelling has demonstrated that the applied load, which changes the crack opening and, subsequently, the contact nonlinearity, significantly affects the amplitude of the second harmonic generated by the fundamental symmetric mode (S0) of Lamb wave. This amplitude is also dependent on the length of the fatigue crack as well as the incident wave angle. The experimental and FE results correlate well, so the modelling approach can be implemented for practical design of damage monitoring systems as well as for the evaluation of the severity of the fatigue cracks.

Depth distribution of chemical phase concentration determined by grazing incidence X-ray diffraction

International Nuclear Information System (INIS)

Novak, P.; Ballo, P.; Dobrocka, E.; Vallo, M.; Lalinsky, T.

2013-01-01

Grazing incidence geometry is widely used in X-ray diffraction analysis of thin films. Penetration depth of radiation can be easily changed by an appropriate selection of the angle of incidence α that enables obtaining information from different depths of the sample. This depth can be decreased up to a nanometer scale by approaching the critical angle α_c for total external reflection. This method therefore provides an efficient tool for the analysis of depth distribution of various structural properties, such as the crystallite size, the amorphous fraction, stress or the concentration of chemical phase. However, absorption of the radiation can be characterized by an average attenuation coefficient μ a special care has to be paid to the last property. Variation of chemical phase concentration with depth usually results in depth dependence on the attenuation coefficient. In this contribution a method for determination of depth distribution of a chemical phase is outlined. The method correctly takes into account the depth variation of the attenuation coefficient. The method is tested on thin oxidized Ir layers. The aim of this paper is a comparison two simple model cases with the experimental results. (authors)

Antibiotics in early life alter the gut microbiome and increase disease incidence in a spontaneous mouse model of autoimmune insulin-dependent diabetes.

Science.gov (United States)

Candon, Sophie; Perez-Arroyo, Alicia; Marquet, Cindy; Valette, Fabrice; Foray, Anne-Perrine; Pelletier, Benjamin; Milani, Christian; Milani, Cristian; Ventura, Marco; Bach, Jean-François; Chatenoud, Lucienne

2015-01-01

Insulin-dependent or type 1 diabetes is a prototypic autoimmune disease whose incidence steadily increased over the past decades in industrialized countries. Recent evidence suggests the importance of the gut microbiota to explain this trend. Here, non-obese diabetic (NOD) mice that spontaneously develop autoimmune type 1 diabetes were treated with different antibiotics to explore the influence of a targeted intestinal dysbiosis in the progression of the disease. A mixture of wide spectrum antibiotics (i.e. streptomycin, colistin and ampicillin) or vancomycin alone were administered orally from the moment of conception, treating breeding pairs, and during the postnatal and adult life until the end of follow-up at 40 weeks. Diabetes incidence significantly and similarly increased in male mice following treatment with these two antibiotic regimens. In NOD females a slight yet not significant trend towards an increase in disease incidence was observed. Changes in gut microbiota composition were assessed by sequencing the V3 region of bacterial 16S rRNA genes. Administration of the antibiotic mixture resulted in near complete ablation of the gut microbiota. Vancomycin treatment led to increased Escherichia, Lactobacillus and Sutterella genera and decreased members of the Clostridiales order and Lachnospiraceae, Prevotellaceae and Rikenellaceae families, as compared to control mice. Massive elimination of IL-17-producing cells, both CD4+TCRαβ+ and TCRγδ+ T cells was observed in the lamina propria of the ileum and the colon of vancomycin-treated mice. These results show that a directed even partial ablation of the gut microbiota, as induced by vancomycin, significantly increases type 1 diabetes incidence in male NOD mice thus prompting for caution in the use of antibiotics in pregnant women and newborns.

Pre-hospital critical care by anaesthesiologist-staffed pre-hospital services in Scandinavia

DEFF Research Database (Denmark)

Krüger, A J; Lossius, H M; Mikkelsen, S

2013-01-01

All Scandinavian countries provide anaesthesiologist-staffed pre-hospital services. Little is known of the incidence of critical illness or injury attended by these services. We aimed to investigate anaesthesiologist-staffed pre-hospital services in Scandinavia with special emphasis on incidence...

Health-Related Quality of Life in Children with Celiac Disease: A Study Based on the Critical Incident Technique

Directory of Open Access Journals (Sweden)

Carlo Catassi

2013-11-01

Full Text Available Celiac Disease (CD is a chronic autoimmune disease triggered by dietary gluten. Gluten avoidance, which is the only available treatment for CD, could impact on quality of life of children with CD. We present the results of a qualitative study on the emotional impact of gluten free diet (GFD on the everyday life of children affected with CD. We investigated 76 celiac patients aged 2–18 years (average age: 9.5 years. By using the Critical Incident Technique (CIT, we defined emotions related to difficulties and awkward situations experienced by the patients. Written answers to open-ended questions from either children (older than 8 years and parents (children younger than 8 years were analyzed qualitatively. We found 80 dilemmas experienced in three different arenas (food situations at school, meals at home, meals outside and characterized lived experiences of children with CD in everyday life (specific emotions, difficulties in relationships and in management of daily life. Children with CD experience strong emotions related to the GFD, permeating several aspects of everyday life. These dilemmas may be missed by a conventional, questionnaire-based approach to the psycho-social consequences of CD treatment.

Critical point predication device

International Nuclear Information System (INIS)

Matsumura, Kazuhiko; Kariyama, Koji.

1996-01-01

An operation for predicting a critical point by using a existent reverse multiplication method has been complicated, and an effective multiplication factor could not be plotted directly to degrade the accuracy for the prediction. The present invention comprises a detector counting memory section for memorizing the counting sent from a power detector which monitors the reactor power, a reverse multiplication factor calculation section for calculating the reverse multiplication factor based on initial countings and current countings of the power detector, and a critical point prediction section for predicting the criticality by the reverse multiplication method relative to effective multiplication factors corresponding to the state of the reactor core previously determined depending on the cases. In addition, a reactor core characteristic calculation section is added for analyzing an effective multiplication factor depending on the state of the reactor core. Then, if the margin up to the criticality is reduced to lower than a predetermined value during critical operation, an alarm is generated to stop the critical operation when generation of a period of more than a predetermined value predicted by succeeding critical operation. With such procedures, forecasting for the critical point can be easily predicted upon critical operation to greatly mitigate an operator's burden and improve handling for the operation. (N.H.)

Integrating incident investigation into the management system

International Nuclear Information System (INIS)

Peterson, E.E.

1992-01-01

In the last 10 yr, the size and frequency of incidents affecting the communities and environment surrounding chemical processing facilities has increased. The chemical process industry, which has always concerned itself with the safety of its facilities, has responded by committing to stricter standards of operation and management. A critical element of these management practices is the use of a structured incident investigation program. Many facilities have implemented and disciplined themselves to perform good investigation of incidents. However, most of these facilities maintain incident investigation as part of their safety management programs. This allows the process to be disconnected from the management system that deals with the day-to-day business of the facility. The first step of integration is understanding the objectives and functions of the management system into which the integration is to occur. To begin, a common definition of management is needed. Management, for the purposes of this discussion, is defined as the system of activities used to control, coordinate, and improve the flow of work within a facility or organization. This definition refers to several concepts that need further development in order to understand how incident investigation can be integrated into a management system, including (a) flow of work, (b) control, and (c) improvement. Application can be made to the nuclear industry

Chain length dependence of the critical density of organic homologous series

DEFF Research Database (Denmark)

Kontogeorgis, Georgios M.; Fredenslund, Aage; Tassios, Dimitrios P.

1995-01-01

Whether the critical density of organic compounds belonging to a certain homologous series increases or decreases with (increasing) molecular weight has been a challenging question over the years. Two sets of experimental data have recently appeared in the literature for the critical density of n......-alkanes: Steele's data (up to n-decane) suggest that critical density increases with carbon number and reaches a limiting value. On the other hand, the data of Teja et al., 1990 which cover a broader range of n-alkanes (up to n-octadecane), reveal a decreasing trend of the critical density after a maximum at n......-heptane. Teja et al. have also presented critical density measurements for 1-alkenes (up to 1-decene) and 1-alkanols (up to 1-undecanol). These data follow the same decreasing trend with the molecular weight as n-alkanes. This trend is not in agreement with the predictions of most group-contribution methods...

Arterial response to shear stress critically depends on endothelial TRPV4 expression.

Directory of Open Access Journals (Sweden)

Veronika Hartmannsgruber

. CONCLUSIONS/SIGNIFICANCE: Genetically encoded loss-of-function of trpv4 results in a loss of shear stress-induced vasodilation, a response pattern critically dependent on endothelial TRPV4 expression. Thus, Ca(2+-influx through endothelial TRPV4 channels is a molecular mechanism contributing significantly to endothelial mechanotransduction.

Arterial Response to Shear Stress Critically Depends on Endothelial TRPV4 Expression

Science.gov (United States)

Kacik, Michael; Kaistha, Anuradha; Grgic, Ivica; Harteneck, Christian; Liedtke, Wolfgang; Hoyer, Joachim; Köhler, Ralf

2007-01-01

/Significance Genetically encoded loss-of-function of trpv4 results in a loss of shear stress-induced vasodilation, a response pattern critically dependent on endothelial TRPV4 expression. Thus, Ca2+-influx through endothelial TRPV4 channels is a molecular mechanism contributing significantly to endothelial mechanotransduction. PMID:17786199

Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: neurocritical patient.

Science.gov (United States)

Acosta Escribano, J; Herrero Meseguer, I; Conejero García-Quijada, R

2011-11-01

Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calorie intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL.

Finite-element modelling of superconductors in over-critical regime with temperature dependent resistivity

International Nuclear Information System (INIS)

Duron, J; Grilli, F; Antognazza, L; Decroux, M; Stavrev, S; Dutoit, B; Fischer, Oe

2006-01-01

In this paper, we present a new numerical model, in which both the thermal and the electromagnetic aspects of the over-critical current regime of HTS materials are taken into account. The electromagnetic and thermal equations have been implemented in finite-element method (FEM) software in order to obtain a novel, closer to reality model for investigating the behaviour of the superconductor when the current exceeds I c . This model has been applied for studying the behaviour of strip lines of an YBCO/Au FCL with a sapphire substrate. Simulations with currents largely exceeding I c have been performed, showing that the total current limitation occurs only when the temperature dependence of the electrical parameters is taken into consideration. Such modelling can replace experiments with currents far exceeding I c which may damage or destroy the studied sample or HTS device

Effect of probiotics on the incidence of ventilator-associated pneumonia in critically ill patients: a randomized controlled multicenter trial.

Science.gov (United States)

Zeng, Juan; Wang, Chun-Ting; Zhang, Fu-Shen; Qi, Feng; Wang, Shi-Fu; Ma, Shuang; Wu, Tie-Jun; Tian, Hui; Tian, Zhao-Tao; Zhang, Shu-Liu; Qu, Yan; Liu, Lu-Yi; Li, Yuan-Zhong; Cui, Song; Zhao, He-Ling; Du, Quan-Sheng; Ma, Zhuang; Li, Chun-Hua; Li, Yun; Si, Min; Chu, Yu-Feng; Meng, Mei; Ren, Hong-Sheng; Zhang, Ji-Cheng; Jiang, Jin-Jiao; Ding, Min; Wang, Yu-Ping

2016-06-01

To evaluate the potential preventive effect of probiotics on ventilator-associated pneumonia (VAP). This was an open-label, randomized, controlled multicenter trial involving 235 critically ill adult patients who were expected to receive mechanical ventilation for ≥48 h. The patients were randomized to receive (1) a probiotics capsule containing live Bacillus subtilis and Enterococcus faecalis (Medilac-S) 0.5 g three times daily through a nasogastric feeding tube plus standard preventive strategies or (2) standard preventive strategies alone, for a maximum of 14 days. The development of VAP was evaluated daily, and throat swabs and gastric aspirate were cultured at baseline and once or twice weekly thereafter. The incidence of microbiologically confirmed VAP in the probiotics group was significantly lower than that in the control patients (36.4 vs. 50.4 %, respectively; P = 0.031). The mean time to develop VAP was significantly longer in the probiotics group than in the control group (10.4 vs. 7.5 days, respectively; P = 0.022). The proportion of patients with acquisition of gastric colonization of potentially pathogenic microorganisms (PPMOs) was lower in the probiotics group (24 %) than the control group (44 %) (P = 0.004). However, the proportion of patients with eradication PPMO colonization on both sites of the oropharynx and stomach were not significantly different between the two groups. The administration of probiotics did not result in any improvement in the incidence of clinically suspected VAP, antimicrobial consumption, duration of mechanical ventilation, mortality and length of hospital stay. Therapy with the probiotic bacteria B. Subtilis and E. faecalis are an effective and safe means for preventing VAP and the acquisition of PPMO colonization in the stomach.

Anomalous incident-angle and elliptical-polarization rotation of an elastically refracted P-wave

Science.gov (United States)

Fa, Lin; Fa, Yuxiao; Zhang, Yandong; Ding, Pengfei; Gong, Jiamin; Li, Guohui; Li, Lijun; Tang, Shaojie; Zhao, Meishan

2015-08-01

We report a newly discovered anomalous incident-angle of an elastically refracted P-wave, arising from a P-wave impinging on an interface between two VTI media with strong anisotropy. This anomalous incident-angle is found to be located in the post-critical incident-angle region corresponding to a refracted P-wave. Invoking Snell’s law for a refracted P-wave provides two distinctive solutions before and after the anomalous incident-angle. For an inhomogeneously refracted and elliptically polarized P-wave at the anomalous incident-angle, its rotational direction experiences an acute variation, from left-hand elliptical to right-hand elliptical polarization. The new findings provide us an enhanced understanding of acoustical-wave scattering and lead potentially to widespread and novel applications.

Impaired Job Performance and Critical Incidents: Factors Influencing Supervisory EAP Referrals.

Science.gov (United States)

Harley, David A.

Relatively little empirical research has been done on the supervisory referral of employees to employee assistance programs (EAPs). Inclusion of constructive confrontation (supervisory referral) into program standards and its continued promotion as a "central strategy" of program theory and operation calls for critical investigation of…

Modes of interaction between nanostructured metal and a conducting mirror as a function of separation and incident polarization

Science.gov (United States)

Bonnie, F.; Arnold, M. D.; Smith, G. B.; Gentle, A. R.

2013-09-01

The optical resonances that occur in nanostructured metal layers are modulated in thin film stacks if the nanostructured layer is separated from a reflecting conducting layer by various thicknesses of thin dielectric. We have measured and modeled the optical response of interacting silver layers, with alumina spacer thickness ranging from a few nm to 50 nm, for s- and p-polarized incident light, and a range of incident angles. Standard thin film models, including standard effective medium models for the nanostructured layer, will break down for spacer thickness below a critical threshold. For example, with polarisation in the film plane and some nano-islands, it may occur at around 10 nm depending on spacer refractive index. Of particular interest here are novel effects observed with the onset of percolation in the nanolayer. Hot spot effects can be modified by nearby mirrors. Other modes to consider include (a) a two-particle mode involving a particle and its mirror image (b) A Fano resonance from hybridisation of localized and de-localised plasmon modes (c) a Babinet's core-(partial) shell particle with metal core-dielectric shell in metal (d) spacing dependent phase modulation (e) the impact of field gradients induced by the mirror at the nano-layer.

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system

International Nuclear Information System (INIS)

Novak, Avrey; Nyflot, Matthew J.; Ermoian, Ralph P.; Jordan, Loucille E.; Sponseller, Patricia A.; Kane, Gabrielle M.; Ford, Eric C.; Zeng, Jing

2016-01-01

Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. Methods: From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflecting potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Results: Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system

Energy Technology Data Exchange (ETDEWEB)

Novak, Avrey; Nyflot, Matthew J.; Ermoian, Ralph P.; Jordan, Loucille E.; Sponseller, Patricia A.; Kane, Gabrielle M.; Ford, Eric C.; Zeng, Jing, E-mail: jzeng13@uw.edu [Department of Radiation Oncology, University of Washington Medical Center, 1959 NE Pacific Street, Campus Box 356043, Seattle, Washington 98195 (United States)

2016-05-15

Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. Methods: From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflecting potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Results: Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically

Development of glancing-incidence and glancing-take-off X-ray fluorescence apparatus for surface and thin-film analyses

International Nuclear Information System (INIS)

Tsuji, Kouichi; Wagatsuma, Kazuaki; Yamada, Takashi; Utaka, Tadashi

1997-01-01

We have studied X-ray fluorescence analysis under glancing incidence and glancing take-off conditions. Recently, we have developed a third apparatus for detecting glancing-incidence and take-off X-ray fluorescence, which makes it possible to measure the incident-angle dependence, the take-off-angle dependence. X-ray reflectivity, and X-ray diffraction. Primarily, we have measured the take-off angular dependence of X-ray fluorescence using this apparatus. Glancing take-off X-ray fluorescence has some advantages in comparison with glancing-incidence X-ray fluorescence. The surface density and the absolute angles were determined by analysing the take-off angle dependence of the fluorescent X-rays emitted from identical atoms with the aid of the reciprocity theorem. (Author)

Antibiotics in early life alter the gut microbiome and increase disease incidence in a spontaneous mouse model of autoimmune insulin-dependent diabetes.

Directory of Open Access Journals (Sweden)

Sophie Candon

Full Text Available Insulin-dependent or type 1 diabetes is a prototypic autoimmune disease whose incidence steadily increased over the past decades in industrialized countries. Recent evidence suggests the importance of the gut microbiota to explain this trend. Here, non-obese diabetic (NOD mice that spontaneously develop autoimmune type 1 diabetes were treated with different antibiotics to explore the influence of a targeted intestinal dysbiosis in the progression of the disease. A mixture of wide spectrum antibiotics (i.e. streptomycin, colistin and ampicillin or vancomycin alone were administered orally from the moment of conception, treating breeding pairs, and during the postnatal and adult life until the end of follow-up at 40 weeks. Diabetes incidence significantly and similarly increased in male mice following treatment with these two antibiotic regimens. In NOD females a slight yet not significant trend towards an increase in disease incidence was observed. Changes in gut microbiota composition were assessed by sequencing the V3 region of bacterial 16S rRNA genes. Administration of the antibiotic mixture resulted in near complete ablation of the gut microbiota. Vancomycin treatment led to increased Escherichia, Lactobacillus and Sutterella genera and decreased members of the Clostridiales order and Lachnospiraceae, Prevotellaceae and Rikenellaceae families, as compared to control mice. Massive elimination of IL-17-producing cells, both CD4+TCRαβ+ and TCRγδ+ T cells was observed in the lamina propria of the ileum and the colon of vancomycin-treated mice. These results show that a directed even partial ablation of the gut microbiota, as induced by vancomycin, significantly increases type 1 diabetes incidence in male NOD mice thus prompting for caution in the use of antibiotics in pregnant women and newborns.

The effect of alpha incident- and poloidal-angle distributions on blister-induced first-wall erosion

International Nuclear Information System (INIS)

Fenske, G.; Hively, L.; Miley, G.

1979-01-01

The incident velocity distribution of high-energy alpha particles bombarding the first wall of an axisymmetric tokamak is evaluated as a function of poloidal angle (theta). The resulting helium concentration profile as a function of the poloidal angle and the implant depth is calculated for a typical Experimental Power Reactor (EPR) design. The critical helium concentration for blistering is first exceeded at theta approx. 55 0 . Peak concentrations are reduced somewhat through continuous D-T sputtering which, dependent on theta, reduces the blister skin thicknesses. The blistering-induced impurity level is found to increase drastically (< approx. 50%), relative to sputtering-induced impurities, at periodic intervals corresponding to approx. 4000 hours operation when each generation of blister begins to exfoliate. (orig.)

Anisotropic critical fields in superconducting superlattices

International Nuclear Information System (INIS)

Banerjee, I.; Yang, Q.S.; Falco, C.M.; Schuller, I.K.

1983-01-01

The temperature and angular dependence of critical fields (H/sub c/) have been studied as a function of layer thickness for superconducting Nb/Cu superlattices. For layer thicknesses between 100 and 300 A, dimensional crossover has been observed in the temperature dependence of H/sub c/. Associated with the crossover we find a change in the angular dependence of H/sub c/ to that given by the effective-mass theory. This is the first time that a relationship has been found between dimensional crossover observed in the temperature dependence and that in the angular dependence of critical fields

[Medicines reconciliation in critically ill patients].

Science.gov (United States)

Lopez-Martin, C; Aquerreta, I; Faus, V; Idoate, A

2014-01-01

Medicines reconciliation plays a key role in patient safety. However, there is limited data available on how this process affects critically ill patients. In this study, we evaluate a program of reconciliation in critically ill patients conducted by the Intensive Care Unit's (ICU) pharmacist. Prospective study about reconciliation medication errors observed in 50 patients. All ICU patients, excluding patients without regular treatment. Reconciliation process was carried out in the first 24h after ICU admission. Discrepancies were clarified with the doctor in charge of the patient. We analyzed the incidence of reconciliation errors, their characteristics and gravity, the interventions made by the pharmacist and their acceptance by physicians. A total of 48% of patients showed at least one reconciliation error. Omission of drugs accounted for 74% of the reconciliation errors, mainly involving antihypertensive drugs (33%). An amount of 58% of reconciliation errors detected corresponded to severity category D. Pharmacist made interventions in the 98% of patients with discrepancies. A total of 81% of interventions were accepted. The incidence and characteristics of reconciliation errors in ICU are similar to those published in non-critically ill patients, and they affect drugs with high clinical significance. Our data support the importance of the stablishment of medication reconciliation proceedings in critically ill patients. The ICU's pharmacist could carry out this procedure adequately. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Cyber Incidents Involving Control Systems

Energy Technology Data Exchange (ETDEWEB)

Robert J. Turk

2005-10-01

The Analysis Function of the US-CERT Control Systems Security Center (CSSC) at the Idaho National Laboratory (INL) has prepared this report to document cyber security incidents for use by the CSSC. The description and analysis of incidents reported herein support three CSSC tasks: establishing a business case; increasing security awareness and private and corporate participation related to enhanced cyber security of control systems; and providing informational material to support model development and prioritize activities for CSSC. The stated mission of CSSC is to reduce vulnerability of critical infrastructure to cyber attack on control systems. As stated in the Incident Management Tool Requirements (August 2005) ''Vulnerability reduction is promoted by risk analysis that tracks actual risk, emphasizes high risk, determines risk reduction as a function of countermeasures, tracks increase of risk due to external influence, and measures success of the vulnerability reduction program''. Process control and Supervisory Control and Data Acquisition (SCADA) systems, with their reliance on proprietary networks and hardware, have long been considered immune to the network attacks that have wreaked so much havoc on corporate information systems. New research indicates this confidence is misplaced--the move to open standards such as Ethernet, Transmission Control Protocol/Internet Protocol, and Web technologies is allowing hackers to take advantage of the control industry's unawareness. Much of the available information about cyber incidents represents a characterization as opposed to an analysis of events. The lack of good analyses reflects an overall weakness in reporting requirements as well as the fact that to date there have been very few serious cyber attacks on control systems. Most companies prefer not to share cyber attack incident data because of potential financial repercussions. Uniform reporting requirements will do much to make this

Pressure dependence of critical temperature of bulk FeSe from spin fluctuation theory

Science.gov (United States)

Hirschfeld, Peter; Kreisel, Andreas; Wang, Yan; Tomic, Milan; Jeschke, Harald; Jacko, Anthony; Valenti, Roser; Maier, Thomas; Scalapino, Douglas

2013-03-01

The critical temperature of the 8K superconductor FeSe is extremely sensitive to pressure, rising to a maximum of 40K at about 10GPa. We test the ability of the current generation of fluctuation exchange pairing theories to account for this effect, by downfolding the density functional theory electronic structure for each pressure to a tight binding model. The Fermi surface found in such a procedure is then used with fixed Hubbard parameters to determine the pairing strength using the random phase approximation for the spin singlet pairing vertex. We find that the evolution of the Fermi surface captured by such an approach is alone not sufficient to explain the observed pressure dependence, and discuss alternative approaches. PJH, YW, AK were supported by DOE DE-FG02-05ER46236, the financial support of MT, HJ, and RV from the DFG Schwerpunktprogramm 1458 is kindly acknowledged.

Two-dimensional critical phenomena

International Nuclear Information System (INIS)

Saleur, H.

1987-09-01

Two dimensional critical systems are studied using transformation to free fields and conformal invariance methods. The relations between the two approaches are also studied. The analytical results obtained generally depend on universality hypotheses or on renormalization group trajectories which are not established rigorously, so numerical verifications, mainly using the transfer matrix approach, are presented. The exact determination of critical exponents; the partition functions of critical models on toruses; and results as the critical point is approached are discussed [fr

'Heads you win, tails I lose': a critical incident study of GPs' decisions about emergency admission referrals.

Science.gov (United States)

Dempsey, Owen P; Bekker, Hilary L

2002-12-01

Acute hospital Trusts' inability to cope with the numbers of emergency admissions has led to the production of guidelines by the Department of Health aimed at reducing inappropriate admissions by GPs. There is a paucity of research describing GPs' decisions to (not) admit patients and it is unclear how effective these guidelines are in changing these practices. To describe GPs' decision-making about referrals for emergency hospital admissions. Observational design using the critical incident technique to elicit data. Eight GPs in West Yorkshire recorded details of memorable emergency admission decisions, both prospective and retrospective consultations. The transcript data were classified by theme using NUD*IST. Forty prospective and 8 retrospective consultations were analysed. Factors affecting GPs' decisions were:Identification of all consequences for all stakeholders in the decision. Emotional impact on the GP of managing these conflicting needs. 'Peer review' of the GP's professionalism about the decision. Contextual pressures limiting effectiveness of GPs' decision-making. Referral decisions require the evaluation of several conflicting consequences for many stakeholders in time-pressured and peer-reviewed situations. These factors encourage the use of heuristics, i.e. GPs' judgements will be influenced more by the social context of the choice than information about the patient's condition. Emergency referral guidelines provide more information to evaluate from another stakeholder; introducing guidelines is likely to increase GPs' use of heuristics and the making of less optimal decisions.

Significant incidents in nuclear fuel cycle facilities

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-03-01

In contrast to nuclear power plants, events in nuclear fuel cycle facilities are not well documented. The INES database covers all the nuclear fuel cycle facilities; however, it was developed in the early 1990s and does not contain information on events prior to that. The purpose of the present report is to collect significant events and analyze them in order to give a safety related overview of nuclear fuel cycle facilities. Significant incidents were selected using the following criteria: release of radioactive material or exposure to radiation; degradation of items important to safety; and deficiencies in design, quality assurance, etc. which include criticality incidents, fire, explosion, radioactive release and contamination. This report includes an explanation, where possible, of root causes, lessons learned and action taken. 4 refs, 4 tabs.

Significant incidents in nuclear fuel cycle facilities

International Nuclear Information System (INIS)

1996-03-01

In contrast to nuclear power plants, events in nuclear fuel cycle facilities are not well documented. The INES database covers all the nuclear fuel cycle facilities; however, it was developed in the early 1990s and does not contain information on events prior to that. The purpose of the present report is to collect significant events and analyze them in order to give a safety related overview of nuclear fuel cycle facilities. Significant incidents were selected using the following criteria: release of radioactive material or exposure to radiation; degradation of items important to safety; and deficiencies in design, quality assurance, etc. which include criticality incidents, fire, explosion, radioactive release and contamination. This report includes an explanation, where possible, of root causes, lessons learned and action taken. 4 refs, 4 tabs

Experimental methods to validate measures of emotional state and readiness for duty in critical operations

International Nuclear Information System (INIS)

Weston, Louise Marie

2007-01-01

A recent report on criticality accidents in nuclear facilities indicates that human error played a major role in a significant number of incidents with serious consequences and that some of these human errors may be related to the emotional state of the individual. A pre-shift test to detect a deleterious emotional state could reduce the occurrence of such errors in critical operations. The effectiveness of pre-shift testing is a challenge because of the need to gather predictive data in a relatively short test period and the potential occurrence of learning effects due to a requirement for frequent testing. This report reviews the different types of reliability and validity methods and testing and statistical analysis procedures to validate measures of emotional state. The ultimate value of a validation study depends upon the percentage of human errors in critical operations that are due to the emotional state of the individual. A review of the literature to identify the most promising predictors of emotional state for this application is highly recommended

Increasing incidence of early onset Type 1 (insulin-dependent) diabetes mellitus: a study of Danish male birth cohorts

DEFF Research Database (Denmark)

Green, A.; Andersen, Per Kragh; Svendsen, A.J.

1992-01-01

To provide information of the incidence trends of Type 1 (insulin-dependent) diabetes mellitus we performed a cohort study of a series of Danish male birth cohorts. All male livebirths in Denmark between 1 January 1949 and 31 December 1964, were investigated regarding the development of Type 1...... of 1705 diabetic subjects were identified of whom 23 were not representative of idiopathic Type 1 diabetes. The cumulative rate of Type 1 diabetes development during the first 20 years of life increased from 2.37 to 2.90 per 1000 for the first eight and last eight birth cohorts, respectively. A log...... diabetes during the first 20 years of life using the files of the Danish Conscript Board, supplemented by a search in the Danish National Registry of Deaths. Diagnosis was verified and clinical information obtained from medical records. The material is estimated to be more than 95% complete. A total...

An Anesthetist’s Experience and the Incidence of Critical Cases in Ambulatory Surgery

Directory of Open Access Journals (Sweden)

R. V. Bolshedvorov

2009-01-01

Full Text Available Objective: to evaluate the impact of experience on the quality of anesthesia in ambulatory surgery. Materials and methods. The authors undertook a study of the role of experience and specialization on the occurrence of complications in ambulatory anesthesia care. By using the internal audit and calculating the frequency of critical cases, they examined the results of the work of two groups of anesthetists: 1 medical beginners after 2-year adjunct practice and 2 one-day hospital specialists having an at least 7-year practice length. Results. In the beginner group, the number of critical cases per operation was twice higher than that in the experienced specialists. The paper shows the detrimental pattern of the residual principle in selecting anesthetists for work at a one-day hospital and provides evidence that specialization is required in the area under discussion. Key words: ambulatory anesthesiology, role of an anesthetist’s experience, critical cases.

Medication incidents reported to an online incident reporting system.

LENUS (Irish Health Repository)

Alrwisan, Adel

2011-01-15

AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

Attitudes and perceived barriers influencing incident reporting by nurses and their correlation with reported incidents: A systematic review.

Science.gov (United States)

Fung, Wing Mei; Koh, Serena Siew Lin; Chow, Yeow Leng

Clinical incident reporting is an integral feature of risk management system in the healthcare sector. By reporting clinical incidents, nurses allow for learning from errors, identification of error patterns and development of error preventive strategies. The need to understand attitudes to reporting, perceived barriers and incident reporting patterns by nurses are the core highlights of this review. INCLUSION CRITERIA: This review considered descriptive quantitative studies that examined nurses' attitudes or perceived barriers towards incident reporting.The participants in this review were nurses working in acute care settings or step-down care settings. Studies that included non-nursing healthcare personnel were excluded.This review considered studies which examined nurses' attitudes towards incident reporting, perceived barriers and incident reporting practices.The outcomes of interest were the attitudes that nurses have towards incident reporting, perceived barriers and the types of reported incidents in correlation with nurses' attitudes and barriers. A three-step search strategy was utilised in this review. An initial limited search of CINAHL and MEDLINE was undertaken. Search strategies were then developed using identified keywords and index terms. Lastly, the reference lists of all identified articles were examined. All searches were limited to studies published in English, between 1991 and 2010. The studies were independently assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Checklist for Descriptive/ Case Series studies. The reviewers extracted data independently from included studies using the Joanna Briggs Institute Data Extraction Form for Descriptive/ Case Series studies. Due to the descriptive nature of the study designs, statistical pooling was not possible. Therefore, the findings of this systematic review are presented in a narrative summary. Fifty-five papers were identified from the searches based on their titles and

Critical currents in columnar vanadium films

International Nuclear Information System (INIS)

Cherkasova, V.G.; Kolin'ko, A.E.; Slatin, A.E.; Fogel, N.Y.

1982-01-01

The angular dependence of the critical current I/sub c/ is studied in columnar vanadium films. In measurements in constant magnetic fields an anomalous maximum I/sub c/ is found on the I/sub c/(theta) curves at arbitrary values of the external magnetic field and temperature, when the magnetic field is perpendicular to the plane of the specimen. The angular dependence of I/sub c/ measured in constant reduced magnetic fields h = H/H/sub c/2(T,theta) shows no singularities in the vicinity of the angle at which the I/sub c/ peak is found in the case H = const, i.e., the critical current is isotropic. This implies that a change in the relative orientation of the vortices and column boundaries produces no change in critical current. The experimental data obtained permit the conclusion that the anisotropy of I/sub c/ observed in a constant magnetic field H is merely a consequence of the anisotropy of the critical magnetic field H/sub c/: the critical current ''tracking'' the magnitude and angular dependence of H/sub c/

Incidence and characteristics of chemical burns.

Science.gov (United States)

Koh, Dong-Hee; Lee, Sang-Gil; Kim, Hwan-Cheol

2017-05-01

Chemical burns can lead to serious health outcomes. Previous studies about chemical burns have been performed based on burn center data so these studies have provided limited information about the incidence of chemical burns at the national level. The aim of this study was to evaluate the incidence and characteristics of chemical burns using nationwide databases. A cohort representing the Korean population, which was established using a national health insurance database, and a nationwide workers' compensation database were used to evaluate the incidence and characteristics of chemical burns. Characteristics of the affected body region, depth of burns, industry, task, and causative agents were analyzed from two databases. The incidence of chemical burns was calculated according to employment status. The most common regions involving chemical burns with hospital visits were the skin followed by the eyes. For skin lesions, the hands and wrists were the most commonly affected regions. Second degree burns were the most common in terms of depth of skin lesions. The hospital visit incidence was 1.96 per 10,000 person-year in the general population. The compensated chemical burns incidence was 0.17 per 10,000 person-year. Employees and the self-employed showed a significantly increased risk of chemical burns undergoing hospital visits compared to their dependents. Chemical burns on the skin and eyes are almost equally prevalent. The working environment was associated with increased risk of chemical burns. Our results may aid in estimating the size of the problem and prioritizing prevention of chemical burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

A critical thinking environment for crisis response

NARCIS (Netherlands)

Ven, J.G.M. van de; Neef, R.M.

2006-01-01

Building up a proper understanding of a large-scale incident is an important and difficult process. We envision a working environment for decision makers in crisis management situations that allows them to work with information in various ways. That will stimulate them to think critically in

Critical behavior of the dielectric constant in asymmetric fluids.

Science.gov (United States)

Bertrand, C E; Sengers, J V; Anisimov, M A

2011-12-08

By applying a thermodynamic theory that incorporates the concept of complete scaling, we derive the asymptotic temperature dependence of the critical behavior of the dielectric constant above the critical temperature along the critical isochore and below the critical temperature along the coexistence curve. The amplitudes of the singular terms in the temperature expansions are related to the changes of the critical temperature and the critical chemical potential upon the introduction of an electric field. The results of the thermodynamic theory are then compared with the critical behavior implied by the classical Clausius-Mossotti approximation. The Clausius-Mossotti approximation fails to account for any singular temperature dependence of the dielectric constant above the critical temperature. Below the critical temperature it produces an apparent asymmetric critical behavior with singular terms similar to those implied by the thermodynamic theory, but with significantly different coefficients. We conclude that the Clausius-Mossotti approximation only can account for the observed asymptotic critical behavior of the dielectric constant when the dependence of the critical temperature on the electric field is negligibly small. © 2011 American Chemical Society

Critical Transition in Critical Zone of Intensively Managed Landscapes

Science.gov (United States)

Kumar, P.

2017-12-01

Intensification of industrial agriculture has resulted in severe unintended global impacts, including degradation of arable land and eutrophication of receiving water bodies. Modern agricultural practices rely on significant direct and indirect human energy inputs, which have created imbalances between increased rates of biogeochemical processes related to production and background rates of natural processes. These imbalances have cascaded through the deep inter-dependencies between carbon, soil, water, nutrient and ecological processes, resulting in a critical transition of the Critical Zone and creating emergent dynamics and evolutionary trajectories. Understanding of these novel organization and function of the Critical Zone is vital for developing sustainable agricultural practices.

Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: A systematic review.

Science.gov (United States)

Gane, E M; Michaleff, Z A; Cottrell, M A; McPhail, S M; Hatton, A L; Panizza, B J; O'Leary, S P

2017-07-01

Shoulder pain and dysfunction may occur following neck dissection among people being treated for head and neck cancer. This systematic review aims to examine the prevalence and incidence of shoulder and neck dysfunction after neck dissection and identify risk factors for these post-operative complications. Electronic databases (Pubmed, CINAHL, EMBASE, Cochrane) were searched for articles including adults undergoing neck dissection for head and neck cancer. Studies that reported prevalence, incidence or risk factors for an outcome of the shoulder or neck were eligible and assessed using the Critical Review Form - Quantitative Studies. Seventy-five articles were included in the final review. Prevalence rates for shoulder pain were slightly higher after RND (range, 10-100%) compared with MRND (range, 0-100%) and SND (range, 9-25%). The incidence of reduced shoulder active range of motion depended on surgery type (range, 5-20%). The prevalence of reduced neck active range of motion after neck dissection was 1-13%. Type of neck dissection was a risk factor for shoulder pain, reduced function and health-related quality of life. The prevalence and incidence of shoulder and neck dysfunction after neck dissection varies by type of surgery performed and measure of dysfunction used. Pre-operative education for patients undergoing neck dissection should acknowledge the potential for post-operative shoulder and neck problems to occur and inform patients that accessory nerve preservation lowers, but does not eliminate, the risk of developing musculoskeletal complications. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Impact of Incidents on Traffic Congestion in Dar es Salaam City

Directory of Open Access Journals (Sweden)

David Mfinanga

2013-06-01

Full Text Available Poorly managed traffic incidents have largely contributed to congestion and delay in the city of Dar es Salaam. A thorough understanding of travel delays caused by incidents is therefore essential for effective countermeasures against the increasing congestion. The method used to determine delays in this research is based on the deterministic queuing theory. Information on incidents was obtained from traffic surveys, traffic police and road users. Counting of the number of vehicles passing the incident location was done on incident and incident-free days. The cumulative traffic counts on incident and incident-free days were then calculated and used to plot the queuing diagram used to determine incident induced delay. This method turned out to be a useful tool for estimating incident induced delay in areas with less sophisticated equipment i.e. where there are no sensors, CCTV cameras, etc. The method provided good estimates of incident induced delay which may help planners and transportation officials in better understanding incident related congestion and in selecting more effective countermeasures against incident related traffic congestion in the city. It was found out that the effects of incidents were different for the different zones, types of incidents and the periods the incident occurred. In addition to the incident duration and the number of vehicles affected, the impact of incidents also depended on availability of alternative routes, number of lanes on the road, discipline of the driver in manoeuvring at incident location and traffic control at the scene.

Temperature dependence of critical magnetic fields for the Abelian Higgs model

International Nuclear Information System (INIS)

Magpantay, J.; Mukku, C.; Sayed, W.A.

1981-05-01

One loop temperature and external electromagnetic field effects on the Abelian Higgs model are studied using the momentum space heat kernel. We obtain expressions for the critical fields necessary for symmetry restoration at some finite temperature and display the critical B vs. T curve separating the broken and restored phases in the B-T plane. (author)

Understanding heterogeneity in borderline personality disorder: differences in affective reactivity explained by the traits of dependency and self-criticism.

Science.gov (United States)

Kopala-Sibley, Daniel C; Zuroff, David C; Russell, Jennifer J; Moskowitz, D S; Paris, Joel

2012-08-01

This study examined whether the personality traits of self-criticism and dependency respectively moderated the effects of perceived inferiority and emotional insecurity on negative affect during interpersonal interactions in individuals with borderline personality disorder (BPD). A sample of 38 patients with BPD and matched community comparison participants completed event-contingent record forms after each significant interaction for a 20-day period. Multilevel models showed that, controlling for baseline levels of depressive symptoms and neuroticism, as well as lagged negative affect, event-level elevations in perceived inferiority and emotional insecurity were related to more negative affect in both groups. Event-level perceived inferiority was more strongly associated with negative affect in patients with BPD who reported higher levels of self-criticism, while event-level perceived emotional insecurity was more strongly associated with negative affect in patients with BPD who reported higher levels of dependency. No significant interactions emerged for the comparison group. These findings further our understanding of differences among patients with BPD and support the application of personality-vulnerability or diathesis-stress models in predicting negative affect in BPD. Results have implications for the design of therapies for patients with BPD. PsycINFO Database Record (c) 2012 APA, all rights reserved.

International Cyber Incident Repository System: Information Sharing on a Global Scale

Energy Technology Data Exchange (ETDEWEB)

Joyce, Amanda L.; Evans, PhD, Nathaniel; Tanzman, Edward A.; Israeli, Daniel

2017-02-02

According to the 2016 Internet Security Threat Report, the largest number of cyber attacks were recorded last year (2015), reaching a total of 430 million incidents throughout the world. As the number of cyber incidents increases, the need for information and intelligence sharing increases, as well. This fairly large increase in cyber incidents is driving the need for an international cyber incident data reporting system. The goal of the cyber incident reporting system is to make available shared and collected information about cyber events among participating international parties. In its 2014 report, Insurance Industry Working Session Readout Report-Insurance for CyberRelated Critical Infrastructure Loss: Key Issues, on the outcomes of a working session on cyber insurance, the U.S. Department of Homeland Security observed that “many participants cited the need for a secure method through which organizations could pool and share cyber incident information” and noted that one underwriter emphasized the importance of internationally harmonized data taxonomies. This cyber incident data reporting system could benefit all nations that take part in reporting incidents to provide a more common operating picture. In addition, this reporting system could allow for trending and anticipated attacks and could potentially benefit participating members by enabling them to get in front of potential attacks. The purpose of this paper is to identify options for consideration for such a system in fostering cooperative cyber defense.

Critical transport current in granular high temperature superconductors

International Nuclear Information System (INIS)

Bogolyubov, N.A.

1999-01-01

The temperature and size dependence of the critical current in a zero magnetic field of three bismuth-based ceramic samples with round cross section and one sample with rectangular triangle cross section have been studied by a contactless technique. It is shown that the critical current can be presented as a product of the temperature and size dependent factors. The temperature-dependent multiplier reflects the individual peculiarities of the Josephson net of each sample, while the size factor is a homogeneous function of the cross-section sizes. The index of this function is independent of the cross-section form, the temperature and individual properties of HTSC samples. The radial distribution of critical current density in round samples and dependence of the critical current density on the magnetic conduction in granular HTSC have been found from the analysis of experimental data

Charge-transport anisotropy in black phosphorus: critical dependence on the number of layers.

Science.gov (United States)

Banerjee, Swastika; Pati, Swapan K

2016-06-28

Phosphorene is a promising candidate for modern electronics because of the anisotropy associated with high electron-hole mobility. Additionally, superior mechanical flexibility allows the strain-engineering of various properties including the transport of charge carriers in phosphorene. In this work, we have shown the criticality of the number of layers to dictate the transport properties of black phosphorus. Trilayer black phosphorus (TBP) has been proposed as an excellent anisotropic material, based on the transport parameters using Boltzmann transport formalisms coupled with density functional theory. The mobilities of both the electron and the hole are found to be higher along the zigzag direction (∼10(4) cm(2) V(-1) s(-1) at 300 K) compared to the armchair direction (∼10(2) cm(2) V(-1) s(-1)), resulting in the intrinsic directional anisotropy. Application of strain leads to additional electron-hole anisotropy with 10(3) fold higher mobility for the electron compared to the hole. Critical strain for maximum anisotropic response has also been determined. Whether the transport anisotropy is due to the spatial or charge-carrier has been determined through analyses of the scattering process of electrons and holes, and their recombination as well as relaxation dynamics. In this context, we have derived two descriptors (S and F(k)), which are general enough for any 2D or quasi-2D systems. Information on the scattering involving purely the carrier states also helps to understand the layer-dependent photoluminescence and electron (hole) relaxation in black phosphorus. Finally, we justify trilayer black phosphorus (TBP) as the material of interest with excellent transport properties.

A Suitable Approach to Estimate Cancer Incidence in Area without Cancer Registry

International Nuclear Information System (INIS)

Mitton, N.; Colonna, M.; Colonna, M.

2011-01-01

Objective. Use of cancer cases from registries and PMSI claims database to estimate Department-specific incidence of four major cancers. Methods. Case extraction used principal diagnosis then surgery codes. PMSI cases/registry cases ratios for 2004 were modelled then Department-specific incidence for 2007 estimated using these ratios and 2007 PMSI cases. Results. For 2007, only colon-rectum and breast cancer estimations were satisfactorily validated for infra national incidence not ovary and kidney cancers. For breast, the estimated national incidence was 50,578 cases and the incidence rate 98.6 cases per 100,000 person per year. For colon-rectum, incidence was 21,172 in men versus 18,327 in women and the incidence rate 38 per 100,000 versus 24.8. For ovary, the estimated incidence was 4,637 and the rate 8.6 per 100,000. For kidney, incidence was 6,775 in men versus 3,273 in women and the rate 13.3 per 100.000 versus 5.2. Conclusion. Incidence estimation using PMSI patient identifiers proved encouraging though still dependent on the assumption of uniform cancer treatments and coding.

Criticality alarm device

International Nuclear Information System (INIS)

Kasai, Kenji.

1994-01-01

The device of the present invention is utilized, for example, to a reprocessing facility for storing and processing nuclear fuels and measures and controls the nuclear fuel assembly system so as not to exceed criticality. That is, a conventional criticality alarm device applies a predetermined processing to neutron fluxes generated from a nuclear fuel assembly system containing nuclear fuels and outputs an alarm. The device of the present invention comprises (1) a neutron flux supply source for increasing and decreasing neutron fluxes periodically and supplying them to nuclear fuel assemblies, (2) a detector for detecting neutron fluxes in the nuclear fuel assemblies, (3) a critical state judging section for judging the critical state of the nuclear fuel assemblies based on the periodically changing signals obtained from the detector (2) and (4) an alarm section for outputting criticality alarms depending on the result of the judgement. The device of the present invention can accurately recognize the critical state of the nuclear fuel assembly system and can forecast reaching of the nuclear fuel assembly to criticality or prompt neutron critical state. (I.S.)

Adapting Cognitive Task Analysis to Investigate Clinical Decision Making and Medication Safety Incidents.

Science.gov (United States)

Russ, Alissa L; Militello, Laura G; Glassman, Peter A; Arthur, Karen J; Zillich, Alan J; Weiner, Michael

2017-05-03

Cognitive task analysis (CTA) can yield valuable insights into healthcare professionals' cognition and inform system design to promote safe, quality care. Our objective was to adapt CTA-the critical decision method, specifically-to investigate patient safety incidents, overcome barriers to implementing this method, and facilitate more widespread use of cognitive task analysis in healthcare. We adapted CTA to facilitate recruitment of healthcare professionals and developed a data collection tool to capture incidents as they occurred. We also leveraged the electronic health record (EHR) to expand data capture and used EHR-stimulated recall to aid reconstruction of safety incidents. We investigated 3 categories of medication-related incidents: adverse drug reactions, drug-drug interactions, and drug-disease interactions. Healthcare professionals submitted incidents, and a subset of incidents was selected for CTA. We analyzed several outcomes to characterize incident capture and completed CTA interviews. We captured 101 incidents. Eighty incidents (79%) met eligibility criteria. We completed 60 CTA interviews, 20 for each incident category. Capturing incidents before interviews allowed us to shorten the interview duration and reduced reliance on healthcare professionals' recall. Incorporating the EHR into CTA enriched data collection. The adapted CTA technique was successful in capturing specific categories of safety incidents. Our approach may be especially useful for investigating safety incidents that healthcare professionals "fix and forget." Our innovations to CTA are expected to expand the application of this method in healthcare and inform a wide range of studies on clinical decision making and patient safety.

The external field dependence of the BCS critical temperature

DEFF Research Database (Denmark)

Frank, Rupert L.; Hainzl, Christian; Seiringer, Robert

2016-01-01

We consider the Bardeen-Cooper-Schrieffer free energy functional for particles interacting via a two-body potential on a microscopic scale and in the presence of weak external fields varying on a macroscopic scale. We study the influence of the external fields on the critical temperature. We show...

Racial Justice, Hegemony, and Bias Incidents in U.S. Higher Education

Science.gov (United States)

Hughes, Glyn

2013-01-01

Formal administrative protocols for responding to bias incidents are now the norm in higher education. In considering these developments, the author of this article poses critical questions about racial justice work on campus, identifies key features of an under-acknowledged institutional racism, and contributes to discussions about ways that…

Teachers' Responses to Bullying Incidents: Effects of Teacher Characteristics and Contexts

Science.gov (United States)

Yoon, Jina; Sulkowski, Michael L.; Bauman, Sheri A.

2016-01-01

School is a critical context of bullying. This study investigated teacher responses to bullying incidents and the effects of individual and contextual variables on these responses. Participating teachers (N = 236) viewed streaming video vignettes depicting physical, verbal, and relational bullying and reported how they would respond to bullies and…

Final Technical Report on Quantifying Dependability Attributes of Software Based Safety Critical Instrumentation and Control Systems in Nuclear Power Plants

International Nuclear Information System (INIS)

Smidts, Carol; Huang, Fuqun; Li, Boyuan; Li, Xiang

2016-01-01

With the current transition from analog to digital instrumentation and control systems in nuclear power plants, the number and variety of software-based systems have significantly increased. The sophisticated nature and increasing complexity of software raises trust in these systems as a significant challenge. The trust placed in a software system is typically termed software dependability. Software dependability analysis faces uncommon challenges since software systems' characteristics differ from those of hardware systems. The lack of systematic science-based methods for quantifying the dependability attributes in software-based instrumentation as well as control systems in safety critical applications has proved itself to be a significant inhibitor to the expanded use of modern digital technology in the nuclear industry. Dependability refers to the ability of a system to deliver a service that can be trusted. Dependability is commonly considered as a general concept that encompasses different attributes, e.g., reliability, safety, security, availability and maintainability. Dependability research has progressed significantly over the last few decades. For example, various assessment models and/or design approaches have been proposed for software reliability, software availability and software maintainability. Advances have also been made to integrate multiple dependability attributes, e.g., integrating security with other dependability attributes, measuring availability and maintainability, modeling reliability and availability, quantifying reliability and security, exploring the dependencies between security and safety and developing integrated analysis models. However, there is still a lack of understanding of the dependencies between various dependability attributes as a whole and of how such dependencies are formed. To address the need for quantification and give a more objective basis to the review process -- therefore reducing regulatory uncertainty

Final Technical Report on Quantifying Dependability Attributes of Software Based Safety Critical Instrumentation and Control Systems in Nuclear Power Plants

Energy Technology Data Exchange (ETDEWEB)

Smidts, Carol [The Ohio State Univ., Columbus, OH (United States); Huang, Funqun [The Ohio State Univ., Columbus, OH (United States); Li, Boyuan [The Ohio State Univ., Columbus, OH (United States); Li, Xiang [The Ohio State Univ., Columbus, OH (United States)

2016-03-25

With the current transition from analog to digital instrumentation and control systems in nuclear power plants, the number and variety of software-based systems have significantly increased. The sophisticated nature and increasing complexity of software raises trust in these systems as a significant challenge. The trust placed in a software system is typically termed software dependability. Software dependability analysis faces uncommon challenges since software systems’ characteristics differ from those of hardware systems. The lack of systematic science-based methods for quantifying the dependability attributes in software-based instrumentation as well as control systems in safety critical applications has proved itself to be a significant inhibitor to the expanded use of modern digital technology in the nuclear industry. Dependability refers to the ability of a system to deliver a service that can be trusted. Dependability is commonly considered as a general concept that encompasses different attributes, e.g., reliability, safety, security, availability and maintainability. Dependability research has progressed significantly over the last few decades. For example, various assessment models and/or design approaches have been proposed for software reliability, software availability and software maintainability. Advances have also been made to integrate multiple dependability attributes, e.g., integrating security with other dependability attributes, measuring availability and maintainability, modeling reliability and availability, quantifying reliability and security, exploring the dependencies between security and safety and developing integrated analysis models. However, there is still a lack of understanding of the dependencies between various dependability attributes as a whole and of how such dependencies are formed. To address the need for quantification and give a more objective basis to the review process -- therefore reducing regulatory uncertainty

Modelling malaria incidence with environmental dependency in a locality of Sudanese savannah area, Mali.

Science.gov (United States)

Gaudart, Jean; Touré, Ousmane; Dessay, Nadine; Dicko, A Lassane; Ranque, Stéphane; Forest, Loic; Demongeot, Jacques; Doumbo, Ogobara K

2009-04-10

The risk of Plasmodium falciparum infection is variable over space and time and this variability is related to environmental variability. Environmental factors affect the biological cycle of both vector and parasite. Despite this strong relationship, environmental effects have rarely been included in malaria transmission models.Remote sensing data on environment were incorporated into a temporal model of the transmission, to forecast the evolution of malaria epidemiology, in a locality of Sudanese savannah area. A dynamic cohort was constituted in June 1996 and followed up until June 2001 in the locality of Bancoumana, Mali. The 15-day composite vegetation index (NDVI), issued from satellite imagery series (NOAA) from July 1981 to December 2006, was used as remote sensing data.The statistical relationship between NDVI and incidence of P. falciparum infection was assessed by ARIMA analysis. ROC analysis provided an NDVI value for the prediction of an increase in incidence of parasitaemia.Malaria transmission was modelled using an SIRS-type model, adapted to Bancoumana's data. Environmental factors influenced vector mortality and aggressiveness, as well as length of the gonotrophic cycle. NDVI observations from 1981 to 2001 were used for the simulation of the extrinsic variable of a hidden Markov chain model. Observations from 2002 to 2006 served as external validation. The seasonal pattern of P. falciparum incidence was significantly explained by NDVI, with a delay of 15 days (p = 0.001). An NDVI threshold of 0.361 (p = 0.007) provided a Diagnostic Odd Ratio (DOR) of 2.64 (CI95% [1.26;5.52]).The deterministic transmission model, with stochastic environmental factor, predicted an endemo-epidemic pattern of malaria infection. The incidences of parasitaemia were adequately modelled, using the observed NDVI as well as the NDVI simulations. Transmission pattern have been modelled and observed values were adequately predicted. The error parameters have shown the smallest

Modelling malaria incidence with environmental dependency in a locality of Sudanese savannah area, Mali

Science.gov (United States)

Gaudart, Jean; Touré, Ousmane; Dessay, Nadine; Dicko, A lassane; Ranque, Stéphane; Forest, Loic; Demongeot, Jacques; Doumbo, Ogobara K

2009-01-01

Background The risk of Plasmodium falciparum infection is variable over space and time and this variability is related to environmental variability. Environmental factors affect the biological cycle of both vector and parasite. Despite this strong relationship, environmental effects have rarely been included in malaria transmission models. Remote sensing data on environment were incorporated into a temporal model of the transmission, to forecast the evolution of malaria epidemiology, in a locality of Sudanese savannah area. Methods A dynamic cohort was constituted in June 1996 and followed up until June 2001 in the locality of Bancoumana, Mali. The 15-day composite vegetation index (NDVI), issued from satellite imagery series (NOAA) from July 1981 to December 2006, was used as remote sensing data. The statistical relationship between NDVI and incidence of P. falciparum infection was assessed by ARIMA analysis. ROC analysis provided an NDVI value for the prediction of an increase in incidence of parasitaemia. Malaria transmission was modelled using an SIRS-type model, adapted to Bancoumana's data. Environmental factors influenced vector mortality and aggressiveness, as well as length of the gonotrophic cycle. NDVI observations from 1981 to 2001 were used for the simulation of the extrinsic variable of a hidden Markov chain model. Observations from 2002 to 2006 served as external validation. Results The seasonal pattern of P. falciparum incidence was significantly explained by NDVI, with a delay of 15 days (p = 0.001). An NDVI threshold of 0.361 (p = 0.007) provided a Diagnostic Odd Ratio (DOR) of 2.64 (CI95% [1.26;5.52]). The deterministic transmission model, with stochastic environmental factor, predicted an endemo-epidemic pattern of malaria infection. The incidences of parasitaemia were adequately modelled, using the observed NDVI as well as the NDVI simulations. Transmission pattern have been modelled and observed values were adequately predicted. The error

Critical Revolutionary Pedagogy Spiced by Pedagogical Love

Science.gov (United States)

FitzSimmons, Robert; Uusiautti, Satu

2013-01-01

The latest incidents demonstrating human beings' inhumanity to their fellow human beings have given impetus to dissect the connection between critical revolutionary pedagogy and the idea of pedagogical love. In this essay we attempt to answer the following questions: How do these two pedagogies complement each other? What can they offer for…

NHD, riverspill, and the development of the incident command tool for drinking water protection.

Science.gov (United States)

William B. Samuels; Rakesh Bahadur; Michael C. Monteith; David E. Amstutz; Jonathan M. Pickus; Katherine Parker; Douglas. Ryan

2006-01-01

This project involved the development of an information tool that gives Incident Commanders the critical information they need to make informed decisions regarding the consequences of threats to public water supply intakes.

Critical frequencies of the ionospheric F1 and F2 layers during the last four solar cycles: Sunspot group type dependencies

Science.gov (United States)

Yiǧit, Erdal; Kilcik, Ali; Elias, Ana Georgina; Dönmez, Burçin; Ozguc, Atila; Yurchshyn, Vasyl; Rozelot, Jean-Pierre

2018-06-01

The long term solar activity dependencies of ionospheric F1 and F2 regions' critical frequencies (f0F1 and f0F2) are analyzed for the last four solar cycles (1976-2015). We show that the ionospheric F1 and F2 regions have different solar activity dependencies in terms of the sunspot group (SG) numbers: F1 region critical frequency (f0F1) peaks at the same time with the small SG numbers, while the f0F2 reaches its maximum at the same time with the large SG numbers, especially during the solar cycle 23. The observed differences in the sensitivity of ionospheric critical frequencies to sunspot group (SG) numbers provide a new insight into the solar activity effects on the ionosphere and space weather. While the F1 layer is influenced by the slow solar wind, which is largely associated with small SGs, the ionospheric F2 layer is more sensitive to Coronal Mass Ejections (CMEs) and fast solar winds, which are mainly produced by large SGs and coronal holes. The SG numbers maximize during of peak of the solar cycle and the number of coronal holes peaks during the sunspot declining phase. During solar minimum there are relatively less large SGs, hence reduced CME and flare activity. These results provide a new perspective for assessing how the different regions of the ionosphere respond to space weather effects.

Using HPV prevalence to predict cervical cancer incidence.

Science.gov (United States)

Sharma, Monisha; Bruni, Laia; Diaz, Mireia; Castellsagué, Xavier; de Sanjosé, Silvia; Bosch, F Xavier; Kim, Jane J

2013-04-15

Knowledge of a country's cervical cancer (CC) burden is critical to informing decisions about resource allocation to combat the disease; however, many countries lack cancer registries to provide such data. We developed a prognostic model to estimate CC incidence rates in countries without cancer registries, leveraging information on human papilloma virus (HPV) prevalence, screening, and other country-level factors. We used multivariate linear regression models to identify predictors of CC incidence in 40 countries. We extracted age-specific HPV prevalence (10-year age groups) by country from a meta-analysis in women with normal cytology (N = 40) and matched to most recent CC incidence rates from Cancer Incidence in Five Continents when available (N = 36), or Globocan 2008 (N = 4). We evaluated country-level behavioral, economic, and public health indicators. CC incidence was significantly associated with age-specific HPV prevalence in women aged 35-64 (adjusted R-squared 0.41) ("base model"). Adding geographic region to the base model increased the adjusted R-squared to 0.77, but the further addition of screening was not statistically significant. Similarly, country-level macro-indicators did not improve predictive validity. Age-specific HPV prevalence at older ages was found to be a better predictor of CC incidence than prevalence in women under 35. However, HPV prevalence could not explain the entire CC burden as many factors modify women's risk of progression to cancer. Geographic region seemed to serve as a proxy for these country-level indicators. Our analysis supports the assertion that conducting a population-based HPV survey targeting women over age 35 can be valuable in approximating the CC risk in a given country. Copyright © 2012 UICC.

The role of social media in providing crisis information in China: a critical evaluation of the Tianjin fire incident

NARCIS (Netherlands)

Li, Xiangfei; Boersma, F.K.

2017-01-01

This paper focusses on the information asymmetry in crisis news after a serious incident in Tianjin, China, in 2015. The incident caused enormous damage and resulted in societal unrest because of the lack of reliable information from the formal media channels. Social media-micro blogs-played a major

Casuistry and its communitarian critics.

Science.gov (United States)

Kuczewski, Mark G

1994-06-01

Communitarian critics have derided case-based reasoning for ignoring the need to arrive at a shared hierarchy of goods prior to case resolution. They claim that such a failure means that casuistry depends on either a naive metaphysical realism or an ethical conventionalism. Casuistry does embrace a certain unobjectionable moral realism and can require appeals to narrative histories, but despite this dependence on the surrounding culture, casuists possess a way to remain critical of society through the concept of practical wisdom and the use of a moral taxonomy. Therefore, casuistry's viability depends upon the existence and employment of this Aristotelian virtue. Furthermore, the casuistry that emerges is a sophisticated type of communitarianism rather than a free-standing method.

Polarization Dependence of Surface Enhanced Raman Scattering on a Single Dielectric Nanowire

Directory of Open Access Journals (Sweden)

Hua Qi

2012-01-01

Full Text Available Our measurements of surface enhanced Raman scattering (SERS on Ga2O3 dielectric nanowires (NWs core/silver composites indicate that the SERS enhancement is highly dependent on the polarization direction of the incident laser light. The polarization dependence of the SERS signal with respect to the direction of a single NW was studied by changing the incident light angle. Further investigations demonstrate that the SERS intensity is not only dependent on the direction and wavelength of the incident light, but also on the species of the SERS active molecule. The largest signals were observed on an NW when the incident 514.5 nm light was polarized perpendicular to the length of the NW, while the opposite phenomenon was observed at the wavelength of 785 nm. Our theoretical simulations of the polarization dependence at 514.5 nm and 785 nm are in good agreement with the experimental results.

Handling of incidents, near-misses

International Nuclear Information System (INIS)

Renborg, Bo; Jonsson, Klas; Broqvist, Kristoffer; Keski-Seppaelae, Sven

2006-12-01

This work has primarily been done as a study of available literature about reporting systems. The following items have also been considered: the participants' experience of safety work in general and reporting systems in particular, as well as correspondence with researchers and organisations that have experience from reporting systems in safety-critical applications. A number of definitions of the English term 'near-miss' have been found in the documentation about safety-critical systems. An important conclusion is that creating a precise definition in itself is not critical. The main objective is to persuade the individuals to report perceived risks as well as actual events or conditions. In this report, we have chosen to use the following definition of what should be reported: A condition or an incident with potential for more serious consequences. The reporting systems that have been evaluated have all data in the same system; they do not divide data into separate systems for incidents or 'near-misses'. The term incident in the literature is not used consistently, especially if both Swedish and English texts are considered. In a large portion of the documentation where the reporting system is mentioned, the focus lies more on analysis than on the problem with the willingness to report. Even when the focus is on reporting it is often dealing with the design of the actual report in order to enable the subsequent treatment of data. In some cases this has led to unnecessary complicated report forms. The cornerstone of a high willingness to report is the creation of a 'no-blame' culture. Based on experience it can be concluded that the question whether a report could lead to personal reprisals is crucial. Even a system that explicitly gives the reporter immunity is still brittle. The bare suspicion (that immunity may vanish) in the mind of the one reporting reduces the willingness to report dramatically. Meaning that the purpose of the analysis of reports must be to

[A Method Research on Environmental Damage Assessment of a Truck Rollover Pollution Incident].

Science.gov (United States)

Cai, Feng; Zhao, Shi-ho; Chen, Gang-cai; Xian, Si-shu; Yang, Qing-ling; Zhou, Xian-jie; Yu, Hai

2015-05-01

With high occurrence of sudden water pollution incident, China faces an increasingly severe situation of water environment. In order to deter the acts of environmental pollution, ensure the damaged resources of environment can be restored and compensated, it is very critical to quantify the economic losses caused by the sudden water pollution incident. This paper took truck rollover pollution incidents in Chongqing for an example, established a set of evaluation method for quantifying the environmental damage, and then assessed the environmental damage by the method from four aspects, including the property damage, ecological environment and resources damages, the costs of administrative affairs in emergency disposal, and the costs of investigation and evaluation.

Estimating the global incidence of traumatic spinal cord injury.

Science.gov (United States)

Fitzharris, M; Cripps, R A; Lee, B B

2014-02-01

Population modelling--forecasting. To estimate the global incidence of traumatic spinal cord injury (TSCI). An initiative of the International Spinal Cord Society (ISCoS) Prevention Committee. Regression techniques were used to derive regional and global estimates of TSCI incidence. Using the findings of 31 published studies, a regression model was fitted using a known number of TSCI cases as the dependent variable and the population at risk as the single independent variable. In the process of deriving TSCI incidence, an alternative TSCI model was specified in an attempt to arrive at an optimal way of estimating the global incidence of TSCI. The global incidence of TSCI was estimated to be 23 cases per 1,000,000 persons in 2007 (179,312 cases per annum). World Health Organization's regional results are provided. Understanding the incidence of TSCI is important for health service planning and for the determination of injury prevention priorities. In the absence of high-quality epidemiological studies of TSCI in each country, the estimation of TSCI obtained through population modelling can be used to overcome known deficits in global spinal cord injury (SCI) data. The incidence of TSCI is context specific, and an alternative regression model demonstrated how TSCI incidence estimates could be improved with additional data. The results highlight the need for data standardisation and comprehensive reporting of national level TSCI data. A step-wise approach from the collation of conventional epidemiological data through to population modelling is suggested.

[The incidence of bilateral multiple primary breast cancer among the female inhabitants of Crimea].

Science.gov (United States)

Tel'kina, G N; Sorkin, V M

1998-08-01

A method is proposed for calculation of PMSO frequency depending on succession of origination of polyneoplasias. The incidence rate of synchronous bilateral breast cancer (BC) was calculated in reference to all primary BC patients and came to 0.75%. The incidence rate of metachronous bilateral BC was calculated depending on the number of those BC patients having been registered every year of observation and it was found to be 5.4%. The total frequency of bilateral BC in a 20-year follow-up in the Crimean region appeared to be 6.15%. The incidence of metachronous bilateral BC was noted to be dependent on the length of follow-up: 1.27 percent and 4.14 percent in the 3- to 10- and 11- to 20-year periods respectively. The risk for the development of bilateral BC is conditioned by the time having elapsed since detection of the first tumor and increases after 10 and 18 years.

Scattered light evidence for short density heights near critical density in laser-irradiated plasmas

International Nuclear Information System (INIS)

Phillion, D.W.; Lerche, R.A.; Rupert, V.C.; Haas, R.A.; Boyle, M.J.

1976-01-01

Experimental evidence is presented of a steepened electron density profile near critical density obtained from studying the time-integrated scattered light from targets illuminated by linearly polarized, 1.06 μ light. Both 10 μ thick disks and DT-filled glass microshells were irradiated by light focused by f/1 or f/2.5 lenses in one and two-beam experiments, respectively. From the dependence of the asymmetry of the scattered light about the beam axis upon the scattering angle, scale lengths on the order of one micron are inferred. Scale lengths have also been deduced from measurements on the polarization state of the reflected light. Both analytic and numerical results are presented to show how the polarization state varies with the incidence angle and the scale length

Modelling malaria incidence with environmental dependency in a locality of Sudanese savannah area, Mali

Directory of Open Access Journals (Sweden)

Demongeot Jacques

2009-04-01

Full Text Available Abstract Background The risk of Plasmodium falciparum infection is variable over space and time and this variability is related to environmental variability. Environmental factors affect the biological cycle of both vector and parasite. Despite this strong relationship, environmental effects have rarely been included in malaria transmission models. Remote sensing data on environment were incorporated into a temporal model of the transmission, to forecast the evolution of malaria epidemiology, in a locality of Sudanese savannah area. Methods A dynamic cohort was constituted in June 1996 and followed up until June 2001 in the locality of Bancoumana, Mali. The 15-day composite vegetation index (NDVI, issued from satellite imagery series (NOAA from July 1981 to December 2006, was used as remote sensing data. The statistical relationship between NDVI and incidence of P. falciparum infection was assessed by ARIMA analysis. ROC analysis provided an NDVI value for the prediction of an increase in incidence of parasitaemia. Malaria transmission was modelled using an SIRS-type model, adapted to Bancoumana's data. Environmental factors influenced vector mortality and aggressiveness, as well as length of the gonotrophic cycle. NDVI observations from 1981 to 2001 were used for the simulation of the extrinsic variable of a hidden Markov chain model. Observations from 2002 to 2006 served as external validation. Results The seasonal pattern of P. falciparum incidence was significantly explained by NDVI, with a delay of 15 days (p = 0.001. An NDVI threshold of 0.361 (p = 0.007 provided a Diagnostic Odd Ratio (DOR of 2.64 (CI95% [1.26;5.52]. The deterministic transmission model, with stochastic environmental factor, predicted an endemo-epidemic pattern of malaria infection. The incidences of parasitaemia were adequately modelled, using the observed NDVI as well as the NDVI simulations. Transmission pattern have been modelled and observed values were adequately

Using mortality data to estimate radiation effects on breast cancer incidence

International Nuclear Information System (INIS)

Hoel, D.G.; Dinse, G.E.

1990-01-01

In this paper we combine Japanese data on radiation exposure and cancer mortality with U.S. data on cancer incidence and lethality to estimate the effects of ionizing radiation on cancer incidence. The analysis is based on the mathematical relationship between the mortality rate and the incidence and lethality rates, as well as on statistical models that relate Japanese incidence rates to U.S. incidence rates and radiation risk factors. Our approach assumes that the risk of death from causes other than the cancer does not depend on whether or not the cancer is present, and among individuals with the cancer, the risk of death attributable to the cancer is the same in Japan and the U.S. and is not affected by radiation exposure. In particular, we focus on the incidence of breast cancer in Japanese women and how this incidence is affected by radiation risk factors. The analysis uses Japanese exposure and mortality data from the Radiation Effects Research Foundation study of atomic bomb survivors and U.S. incidence and lethality data from the Surveillance, Epidemiology, and End Results Registry. Even without Japanese incidence data, we obtain reasonable estimates of the incidence of breast cancer in unexposed Japanese women and identify the radiation risk factors that affect this incidence. Our analysis demonstrates that the age at exposure is an important risk factor, but that the incidence of breast cancer is not affected by the city of residence (Nagasaki versus Hiroshima) or the time since exposure

Dependence of secondary electron emission on the incident angle and the energy of primary electrons bombarding bowl-structured beryllium surfaces

International Nuclear Information System (INIS)

Kawata, Jun; Ohya, Kaoru.

1994-01-01

A Monte Carlo simulation of the secondary electron emission from beryllium is combined with a model of bowl structure for surface roughness, for analyzing the difference between the electron emissions for normal and oblique incidences. At normal incidence, with increasing the roughness parameter H/W, the primary energy E pm at which the maximum electron yield occurs becomes higher, and at more than the E pm , the decrease in the yield is slower; where H and W are the depth and width of the bowl structure, respectively. The dispersion of incident angle to the microscopic surface causes a small increase in the yield at oblique incidence, whereas the blocking of primary electrons from bombarding the bottom of the structure causes an opposite trend. The strong anisotropy in the polar angular distribution with respect to the azimuthal angle is calculated at oblique incidence. (author)

Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit.

Science.gov (United States)

González-Méndez, María Isabel; Lima-Serrano, Marta; Martín-Castaño, Catalina; Alonso-Araujo, Inmaculada; Lima-Rodríguez, Joaquín Salvador

2018-03-01

To determinate the incidence, incidence rate and risk factors of pressure ulcers in critical care patients. Pressure ulcers represent one of the most frequent health problems in clinical practice. Specifically, critical patients who are hospitalised in intensive care units have a higher risk of developing a pressure ulcer, with an incidence that fluctuates between 3.3-39.3% according to previous studies. Prospective cohort study. Three hundred and thirty-five adult patients (over 18 years old) who were hospitalised in intensive care units for at least 24 hr were monitored for a maximum of 32 days. They were excluded if they had a pressure ulcers at admission. The survival rate for pressure ulcers, from stages I-IV, was calculated using the Kaplan-Meier method. A multivariate Cox regression model was adjusted to identify the main risk factors for pressure ulcers: demographic, clinical, prognostic and therapeutic variables. The incidence of pressure ulcers in critical patients was 8.1%, and the incidence rate was 11.72 pressure ulcers for 1,000 days of intensive care units stay; 40.6% of pressure ulcers were of stage I and 59.4% of stage II, mainly in the sacrum. According to the Cox model, the main risk factors for pressure ulcers were in-hospital complications, prognostic scoring system (SAPS III) and length of immobilisation. The incidence of pressure ulcers is lower than that shown in recent studies. Complications on the unit and the prognosis score were risk factors associated with pressure ulcers but, surprisingly, length of immobilisation was a protective factor. Survival analysis of pressure ulcer allows for identification of risk factors associated with this health problem in the intensive care units. Identifying these factors can help nurses establish interventions to prevent pressure ulcers in this healthcare scenario, given that pressure ulcers prevention is an indicator of nursing quality. © 2017 John Wiley & Sons Ltd.

Health professionals' beliefs about domestic abuse and the issue of disclosure: a critical incident technique study.

Science.gov (United States)

Taylor, Julie; Bradbury-Jones, Caroline; Kroll, Thilo; Duncan, Fiona

2013-09-01

Domestic abuse is increasingly recognised as a serious, worldwide public health concern. There is a significant body of literature regarding domestic abuse, but little is known about health professionals' beliefs about domestic abuse disclosure. In addition, the intersection between health professionals' beliefs and abused women's views remains uninvestigated. We report on a two-phase, qualitative study using Critical Incident Technique (CIT) that aimed to explore community health professionals' beliefs about domestic abuse and the issue of disclosure. We investigated this from the perspectives of both health professionals and abused women. The study took place in Scotland during 2011. The study was informed theoretically by the Common Sense Model of Self-Regulation of Health and Illness (CSM). This model is typically used in disease-orientated research. In our innovative use, however, CSM was used to study the social phenomenon, domestic abuse. The study involved semi-structured, individual CIT interviews with health professionals and focus groups with women who had experienced domestic abuse. Twenty-nine health professionals (Midwives, Health Visitors and General Practitioners) participated in the first phase of the study. In the second phase, three focus groups were conducted with a total of 14 women. Data were analysed using a combination of an inductive classification and framework analysis. Findings highlight the points of convergence and divergence between abused women's and health professionals' beliefs about abuse. Although there was some agreement, they do not always share the same views. For example, women want to be asked about abuse, but many health professionals do not feel confident or comfortable discussing the issue. Overall, the study shows the dynamic interaction between women's and health professionals' beliefs about domestic abuse and readiness to discuss and respond to it. Understanding these complex dynamics assists in the employment of

Criticality safety

International Nuclear Information System (INIS)

Walker, G.

1983-01-01

When a sufficient quantity of fissile material is brought together a self-sustaining neutron chain reaction will be started in it and will continue until some change occurs in the fissile material to stop the chain reaction. The quantity of fissile material required is the 'Critical Mass'. This is not a fixed quantity even for a given type of fissile material but varies between quite wide limits depending on a number of factors. In a nuclear reactor the critical mass of fissile material is assembled under well-defined condition to produce a controllable chain reaction. The same materials have to be handled outside the reactor in all stages of fuel element manufacture, storage, transport and irradiated fuel reprocessing. At any stage it is possible (at least in principle) to assemble a critical mass and thus initiate an accidental and uncontrollable chain reaction. Avoiding this is what criticality safety is all about. A system is just critical when the rate of production of neutrons balances the rate of loss either by escape or by absorption. The factors affecting criticality are, therefore, those which effect neutron production and loss. The principal ones are:- type of nuclide and enrichment (or isotopic composition), moderation, reflection, concentration (density), shape and interaction. Each factor is considered in detail. (author)

Critical energy of superconducting composites

International Nuclear Information System (INIS)

Jayakumar, R.

1987-01-01

The stability of superconducting composites is studied in one-dimensional geometry and critical quench energies are calculated by solving for the steady state temperature profile which gives the minimum energy. The present calculations give lower values for the critical energy than previous estimates. The calculations are shown to be applicable to both direct cooled and impregnated conductors. Critical energies are also calculated including the effect of temperature dependence of conductor properties. (author)

Definition of areas requiring criticality alarm annunciation and emergency control

International Nuclear Information System (INIS)

Hobson, J.M.

1988-01-01

The design of fissile material handling at British Nuclear Fuels plc requires the provision of a criticality incident detection system unless a specific case for omission can be formally made. Where such systems are provided, the 100 mSv contour resulting from a reference criticality incident must be restricted to an area of administrative control within which it is reasonably practicable to provide alarm annunciation and for which emergency arrangements can be defined. For typical reprocessing plant applications, the definition of these areas, and their restriction by provision of shielding where necessary, potentially requires a very large number of three dimensional neutron transport calculations in complex geometries. However, by considering the requirements and nature of this assessment, simple generic methods have been developed and justified. Consequently, rapid and inexpensive assessments of control areas can be carried out

Critical behavior of ferromagnetic Ising thin films

International Nuclear Information System (INIS)

Cossio, P.; Mazo-Zuluaga, J.; Restrepo, J.

2006-01-01

In the present work, we study the magnetic properties and critical behavior of simple cubic ferromagnetic thin films. We simulate LxLxd films with semifree boundary conditions on the basis of the Monte Carlo method and the Ising model with nearest neighbor interactions. A Metropolis dynamics was implemented to carry out the energy minimization process. For different film thickness, in the nanometer range, we compute the temperature dependence of the magnetization, the magnetic susceptibility and the fourth order Binder's cumulant. Bulk and surface contributions of these quantities are computed in a differentiated fashion. Additionally, according to finite size scaling theory, we estimate the critical exponents for the correlation length, magnetic susceptibility, and magnetization. Results reveal a strong dependence of critical temperature and critical exponents on the film thickness. The obtained critical exponents are finally compared to those reported in literature for thin films

Washing and chilling as critical control points in pork slaughter hazard analysis and critical control point (HACCP) systems.

Science.gov (United States)

Bolton, D J; Pearce, R A; Sheridan, J J; Blair, I S; McDowell, D A; Harrington, D

2002-01-01

The aim of this research was to examine the effects of preslaughter washing, pre-evisceration washing, final carcass washing and chilling on final carcass quality and to evaluate these operations as possible critical control points (CCPs) within a pork slaughter hazard analysis and critical control point (HACCP) system. This study estimated bacterial numbers (total viable counts) and the incidence of Salmonella at three surface locations (ham, belly and neck) on 60 animals/carcasses processed through a small commercial pork abattoir (80 pigs d(-1)). Significant reductions (P HACCP in pork slaughter plants. This research will provide a sound scientific basis on which to develop and implement effective HACCP in pork abattoirs.

Reproducibility of The Random Incidence Absorption Coefficient Converted From the Sabine Absorption Coefficient

DEFF Research Database (Denmark)

Jeong, Cheol-Ho; Chang, Ji-ho

2015-01-01

largely depending on the test room. Several conversion methods for porous absorbers from the Sabine absorption coefficient to the random incidence absorption coefficient were suggested by considering the finite size of a test specimen and non-uniformly incident energy onto the specimen, which turned out...... resistivity optimization outperforms the surface impedance optimization in terms of the reproducibility....

The dependence of critical current density of GdFeCo layer on composition of thermally assisted STT-RAM

Science.gov (United States)

Dai, B.; Zhu, J.; Liu, K.; Yang, L.; Han, J.

2017-07-01

Amorphous rare earth-transitional metal (RETM) GdFeCo memory layer with RE- and TM-rich compositions was fabricated in stacks of GdFeCo (10 nm)/Cu (3 nm)/[Co(0.2 nm)/Pd(0.4 nm)]6. Their magnetic properties and spin transfer torque (STT) switching of magnetization were investigated. The maximum magneto-resistance (MR) was around 0.24% for the TM-rich Gd21.4 (Fe90Co10)78.6 memory layer and was -0.03% for the RE-rich Gd29.0 (Fe90Co10)71.0 memory layer. The critical current densities Jc to switch the GdFeCo memory layers are in the range of 1.4 × 107 A/cm2-4.5 × 107 A/cm2. The dependence of critical current density Jc and effective anisotropy constant Keff on Gd composition were also investigated. Both Jc and Keff have maximum values in the Gd composition range from 21-29 at.%, suitable for thermally assisted STT-RAM for storage density exceeding Gb/inch2.

Association of anxiety disorders and depression with incident heart failure.

Science.gov (United States)

Garfield, Lauren D; Scherrer, Jeffrey F; Hauptman, Paul J; Freedland, Kenneth E; Chrusciel, Tim; Balasubramanian, Sumitra; Carney, Robert M; Newcomer, John W; Owen, Richard; Bucholz, Kathleen K; Lustman, Patrick J

2014-02-01

Depression has been associated with increased risk of heart failure (HF). Because anxiety is highly comorbid with depression, we sought to establish if anxiety, depression, or their co-occurrence is associated with incident HF. A retrospective cohort (N = 236,079) including Veteran's Administration patients (age, 50-80 years) free of cardiovascular disease (CVD) at baseline was followed up between 2001 and 2007. Cox proportional hazards models were computed to estimate the association between anxiety disorders alone, major depressive disorder (MDD) alone, and the combination of anxiety and MDD, with incident HF before and after adjusting for sociodemographics, CVD risk factors (Type 2 diabetes, hypertension, hyperlipidemia, obesity), nicotine dependence/personal history of tobacco use, substance use disorders (alcohol and illicit drug abuse/dependence), and psychotropic medication. Compared with unaffected patients, those with anxiety only, MDD only, and both disorders were at increased risk for incident HF in age-adjusted models (hazard ratio [HR] = 1.19 [ 95% confidence interval {CI} = 1.10-1.28], HR = 1.21 [95% CI = 1.13-1.28], and HR = 1.24 [95% CI = 1.17-1.32], respectively). After controlling for psychotropics in a full model, the association between anxiety only, MDD only, and both disorders and incident HF increased (HRs = 1.46, 1.56, and 1.74, respectively). Anxiety disorders, MDD, and co-occurring anxiety and MDD are associated with incident HF in this large cohort of Veteran's Administration patients free of CVD at baseline. This risk of HF is greater after accounting for protective effects of psychotropic medications. Prospective studies are needed to clarify the role of depression and anxiety and their pharmacological treatment in the etiology of HF.

Teaching Critical Thinking in Undergraduate Science Courses

Science.gov (United States)

Hager, Paul; Sleet, Ray; Logan, Peter; Hooper, Mal

This paper reports on the design and evaluation of a project aimed at fostering the critical thinking abilities and dispositions of first year students at an Australian university. Novel paper and pencil problems were designed to foster the range of critical thinking abilities identified by Ennis (1991). Most of these critical thinking tasks relate to applications of chemistry and physics in everyday life. Some of the tasks were developed from information and/or ideas obtained from critical incident interviews with scientists in private and government organisations. The first year university students were required to attempt the tasks in co-operative groups and to interact in these groups in ways aimed at fostering the dispositions of Ennis' ideal critical thinker (Ennis 1996).The project was evaluated from discussions with groups of students, from comments of tutors who observed the students working in groups and from a questionnaire. Evidence obtained from these data indicated that many students considered their thinking skills were enhanced by their experience of attempting the tasks in small co-operative groups.

Field, temperature, and angle dependent critical current density Jc(H,T, ) in coated conductors obtained via contact-free methods

Energy Technology Data Exchange (ETDEWEB)

Thompson, James R [ORNL; Sinclair IV, John W [ORNL; Christen, David K [ORNL; Zhang, Yifei [ORNL; Zuev, Yuri L [ORNL; Cantoni, Claudia [ORNL; Chen, Y [SuperPower Incorporated, Schenectady, New York; Selvamanickam, V. [SuperPower Incorporated, Schenectady, New York

2010-01-01

Applications of coated conductors based on high-Tc superconductors often require detailed knowledge of their critical current density Jc as a function of magnetic field orientation as well as field strength and temperature. This work demonstrates experimental methods to obtain the angularly dependent Jc using contact-free magnetic measurements, and qualifies those methods using several well defined conditions. The studies complement traditional transport techniques and are readily extended to conditions of field and temperature where the current density is very large and transport methods become difficult. Results on representative materials are presented.

Depth-dependent positron annihilation in different polymers

Energy Technology Data Exchange (ETDEWEB)

Yang, J.; Zhang, P.; Cheng, G.D.; Li, D.X.; Wu, H.B.; Li, Z.X.; Cao, X.Z. [Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, No. 19 Yuquan Lu, Beijing 100049 (China); Jia, Q.J. [Beijing Synchrotron Radiation Facility, Institute of High Energy Physics, Chinese Academy of Sciences, No. 19 Yuquan Lu, Beijing 100049 (China); Yu, R.S. [Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, No. 19 Yuquan Lu, Beijing 100049 (China); Wang, B.Y., E-mail: wangboy@ihep.ac.cn [Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, No. 19 Yuquan Lu, Beijing 100049 (China)

2013-09-01

Depth-dependent positron annihilation Doppler broadening measurements were conducted for polymers with different chemical compositions. Variations of the S parameter with respect to incident positron energy were observed. For pure hydrocarbons PP, HDPE and oxygen-containing polymer PC, S parameter rises with increasing positron implantation depth. While for PI and fluoropolymers like PTFE, ETFE and PVF, S parameter decreases with higher positron energy. For chlorine-containing polymer PVDC, S parameter remains nearly constant at all incident positron energies. It is suggested that these three variation trends are resulted from a competitive effect between the depth-dependent positronium formation and the influence of highly electronegative atoms on positron annihilation characteristics.

[Alcohol dependence in homeless men. Incidence, development and determinants].

Science.gov (United States)

Dufeu, P; Podschus, J; Schmidt, L G

1996-11-01

Against the background of the complex relationship of alcoholism and homelessness, we investigated the question of whether homeless alcoholics and those with homes differed regarding biographical and clinical variables. Therefore, 49 of 72 (68.1%) homeless male visitors to a city kitchen in the center of Berlin, who had fulfilled the ICD-10 criteria for the alcohol-dependence syndrome, were compared with 141 outpatients of the addiction research unit of the Department of Psychiatry of the Free University of Berlin. It was found that homeless alcoholics had more psychosocial disadvantages than other alcoholics. They had been raised more frequently in families with an alcoholic father or mother and a higher number of children. The level of education and job qualification was lower in the homeless alcoholics. Early homelessness was predicted by a lack of sexual behavior (no partnership experienced) and a family history of alcoholism. In the interview, homeless alcoholics reported fewer symptoms of alcohol-dependence syndrome than other alcoholics; however, the first symptoms had been experienced earlier. Alcohol-related somatic and psychological consequences were reported more frequently in alcoholics with homes, whereas social problems were more common in the homeless subjects. The results are discussed in the light of methodological limitations and other reports on the topic.

Critical behavior in inhomogeneous random graphs

NARCIS (Netherlands)

Hofstad, van der R.W.

2009-01-01

We study the critical behavior of inhomogeneous random graphs where edges are present independently but with unequal edge occupation probabilities. We show that the critical behavior depends sensitively on the properties of the asymptotic degrees. Indeed, when the proportion of vertices with degree

Appraisal of snakebite incidence and mortality in Bolivia.

Science.gov (United States)

Chippaux, Jean-Philippe; Postigo, Jorge R

2014-06-01

No information has been yet published on snakebite in Bolivia. The country includes very different ecological situations leading to various epidemiological risks. A study has been carried out to evaluate the incidence and location of snakebite, particularly in relation with altitude, in order to improve management. Investigations on snakebite epidemiology were based on a) cases treated in health facilities as reported by health authorities and b) household surveys carried out in areas with high variations of altitude, in various regions of Bolivia. An average of 700 bites was treated each year in Bolivia (national annual incidence = 8 bites per 100,000 people) with a great disparity between districts. Household surveys showed annual incidences ranged from 30 to 110 bites per 100,000 inhabitants depending on location. Annual mortality ranged 0.1-3.9 per 100,000 people. A significant and constant inverse correlation was shown between snakebite incidence and altitude, which may be explained by both snake and human distributions and activities. Notification of snakebite is useful for improving patient management and informing antivenom distribution. It should also involve the report of deaths and clinical details of envenomation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sample size methods for estimating HIV incidence from cross-sectional surveys.

Science.gov (United States)

Konikoff, Jacob; Brookmeyer, Ron

2015-12-01

Understanding HIV incidence, the rate at which new infections occur in populations, is critical for tracking and surveillance of the epidemic. In this article, we derive methods for determining sample sizes for cross-sectional surveys to estimate incidence with sufficient precision. We further show how to specify sample sizes for two successive cross-sectional surveys to detect changes in incidence with adequate power. In these surveys biomarkers such as CD4 cell count, viral load, and recently developed serological assays are used to determine which individuals are in an early disease stage of infection. The total number of individuals in this stage, divided by the number of people who are uninfected, is used to approximate the incidence rate. Our methods account for uncertainty in the durations of time spent in the biomarker defined early disease stage. We find that failure to account for this uncertainty when designing surveys can lead to imprecise estimates of incidence and underpowered studies. We evaluated our sample size methods in simulations and found that they performed well in a variety of underlying epidemics. Code for implementing our methods in R is available with this article at the Biometrics website on Wiley Online Library. © 2015, The International Biometric Society.

Scattered light evidence for short density scale heights near critical density in laser-irradiated plasmas

International Nuclear Information System (INIS)

Phillion, D.W.; Lerche, R.A.; Rupert, V.C.; Haas, R.A.; Boyle, M.J.

1976-01-01

Experimental evidence is presented of a steepened electron density profile near critical density obtained from studying the time-integrated scattered light from targets illuminated by linearly polarized, 1.06 μ light. Both 10 μ thick disks and DT-filled glass microshells were irradiated by light focused by f/1 or f/2.5 lenses in one and two-beam experiments, respectively. From the dependence of the asymmetry of the scattered light about the beam axis upon the scattering angle, we infer scale lengths on the order of one micron. Scale lengths have also been deduced from measurements on the polarization state of the reflected light. Both analytic and numerical results are presented to show how the polarization state varies with the incidence angle and the scale length

Hiding Critical Targets in Smart Grid Networks

Energy Technology Data Exchange (ETDEWEB)

Bao, Wei [Univ. of Arkansas, Fayetteville, AR (United States); Li, Qinghua

2017-10-23

With the integration of advanced communication technologies, the power grid is expected to greatly enhance efficiency and reliability of future power systems. However, since most electrical devices in power grid substations are connected via communication networks, cyber security of these communication networks becomes a critical issue. Real-World incidents such as Stuxnet have shown the feasibility of compromising a device in the power grid network to further launch more sophisticated attacks. To deal with security attacks of this spirit, this paper aims to hide critical targets from compromised internal nodes and hence protect them from further attacks launched by those compromised nodes. In particular, we consider substation networks and propose to add carefully-controlled dummy traffic to a substation network to make critical target nodes indistinguishable from other nodes in network traffic patterns. This paper describes the design and evaluation of such a scheme. Evaluations show that the scheme can effectively protect critical nodes with acceptable communication cost.

Analysing context-dependent deviations in interacting with safety-critical systems

International Nuclear Information System (INIS)

Paterno, Fabio; Santoro, Carmen

2006-01-01

Mobile technology is penetrating many areas of human life. This implies that the context of use can vary in many respects. We present a method that aims to support designers in managing the complex design space when considering applications with varying contexts and help them to identify solutions that support users in performing their activities while preserving usability and safety. The method is a novel combination of an analysis of both potential deviations in task performance and most suitable information representations based on distributed cognition. The originality of the contribution is in providing a conceptual tool for better understanding the impact of context of use on user interaction in safety-critical domains. In order to present our approach we provide an example in which the implications of introducing new support through mobile devices in a safety-critical system are identified and analysed in terms of potential hazards

Age-Dependence and Aging-Dependence: Neuronal Loss and Lifespan in a C. elegans Model of Parkinson's Disease.

Science.gov (United States)

Apfeld, Javier; Fontana, Walter

2017-12-23

It is often assumed, but not established, that the major neurodegenerative diseases, such as Parkinson's disease, are not just age-dependent (their incidence changes with time) but actually aging-dependent (their incidence is coupled to the process that determines lifespan). To determine a dependence on the aging process requires the joint probability distribution of disease onset and lifespan. For human Parkinson's disease, such a joint distribution is not available, because the disease cuts lifespan short. To acquire a joint distribution, we resorted to an established C. elegans model of Parkinson's disease in which the loss of dopaminergic neurons is not fatal. We find that lifespan is not correlated with the loss of individual neurons. Therefore, neuronal loss is age-dependent and aging-independent. We also find that a lifespan-extending intervention into insulin/IGF1 signaling accelerates the loss of specific dopaminergic neurons, while leaving death and neuronal loss times uncorrelated. This suggests that distinct and compartmentalized instances of the same genetically encoded insulin/IGF1 signaling machinery act independently to control neurodegeneration and lifespan in C. elegans . Although the human context might well be different, our study calls attention to the need to maintain a rigorous distinction between age-dependence and aging-dependence.

An isodose shift technique for obliquely incident electron beams

International Nuclear Information System (INIS)

Ulin, K.; Sternick, E.S.

1989-01-01

It is well known that when an electron beam is incident obliquely on the surface of a phantom, the depth dose curve measured normal to the surface is shifted toward the surface. Based on geometrical arguments alone, the depth of the nth isodose line for an electron beam incident at an angle θ should be equal to the product of cos θ and the depth of the nth isodose line at normal incidence. This method, however, ignores the effects of scatter and can lead to significant errors in isodose placement for beams at large angles of incidence. A semi-empirical functional relationship and a table of isodose shift factors have been developed with which one may easily calculate the depth of any isodose line for beams at incident angles of 0 degree to 60 degree. The isodose shift factors are tabulated in terms of beam energy (6--22 MeV) and isodose line (10%--90%) and are shown to be relatively independent of beam size and incident angle for angles <60 degree. Extensive measurements have been made on a Varian Clinac 2500 linear accelerator with a parallel-plate chamber and polystyrene phantom. The dependence of the chamber response on beam angulation has been checked, and the scaling factor of the polystyrene phantom has been determined to be equal to 1.00

Challenges faced by nurses in managing pain in a critical care setting.

Science.gov (United States)

Subramanian, Pathmawathi; Allcock, Nick; James, Veronica; Lathlean, Judith

2012-05-01

To explore nurses' challenges in managing pain among ill patients in critical care. Pain can lead to many adverse medical consequences and providing pain relief is central to caring for ill patients. Effective pain management is vital since studies show patients admitted to critical care units still suffer from significant levels of acute pain. The effective delivery of care in clinical areas remains a challenge for nurses involved with care which is dynamic and constantly changing in critically ill. Qualitative prospective exploratory design. This study employed semi structured interviews with nurses, using critical incident technique. Twenty-one nurses were selected from critical care settings from a large acute teaching health care trust in the UK. A critical incident interview guide was constructed from the literature and used to elicit responses. Framework analysis showed that nurses perceived four main challenges in managing pain namely lack of clinical guidelines, lack of structured pain assessment tool, limited autonomy in decision making and the patient's condition itself. Nurses' decision making and pain management can influence the quality of care given to critically ill patients. It is important to overcome the clinical problems that are faced when dealing with pain experience. There is a need for nursing education on pain management. Providing up to date and practical strategies may help to reduce nurses' challenges in managing pain among critically ill patients. Broader autonomy and effective decision making can be seen as beneficial for the nurses besides having a clearer and structured pain management guidelines. © 2011 Blackwell Publishing Ltd.

Defining groundwater-dependent ecosystems and assessing critical water needs for their foundational plant communities

Science.gov (United States)

Stella, J. C.

2017-12-01

In many water-limited regions, human water use in conjunction with increased climate variability threaten the sustainability of groundwater-dependent plant communities and the ecosystems that depend on them (GDEs). Identifying and delineating vulnerable GDEs and determining critical functional thresholds for their foundational species has proved challenging, but recent research across several disciplines shows great promise for reducing scientific uncertainty and increasing applicability to ecosystem and groundwater management. Combining interdisciplinary approaches provides insights into indicators that may serve as early indicators of ecosystem decline, or alternatively demonstrate lags in responses depending on scale or sensitivity, or that even may decouple over time (Fig. 1). At the plant scale, miniaturization of plant sap flow sensors and tensiometers allow for non-destructive, continual measurements of plant water status in response to environmental stressors. Novel applications of proven tree-ring and stable isotope methods provide multi-decadal chronologies of radial growth, physiological function (using d13C ratios) and source water use (using d18O ratios) in response to annual variation in climate and subsurface water availability to plant roots. At a landscape scale, integration of disparate geospatial data such as hyperspectral imagery and LiDAR, as well as novel spectral mixing analysis promote the development of novel water stress indices such as vegetation greenness and non-photosynthetic (i.e., dead) vegetation (Fig. 2), as well as change detection using time series (Fig. 3). Furthermore, increases in data resolution across numerous data types can increasingly differentiate individual plant species, including sensitive taxa that serve as early warning indicators of ecosystem impairment. Combining and cross-calibrating these approaches provide insight into the full range of GDE response to environmental change, including increased climate drought

Low pacemaker incidence with continuous-sutured valves: a retrospective analysis.

Science.gov (United States)

Niclauss, Lars; Delay, Dominique; Pfister, Raymond; Colombier, Sebastien; Kirsch, Matthias; Prêtre, René

2017-06-01

Background Permanent pacemaker implantation after surgical aortic valve replacement depends on patient selection and risk factors for conduction disorders. We aimed to identify risk criteria and obtain a selected group comparable to patients assigned to transcatheter aortic valve implantation. Methods Isolated sutured aortic valve replacements in 994 patients treated from 2007 to 2015 were reviewed. Demographics, hospital stay, preexisting conduction disorders, surgical technique, and etiology in patients with and without permanent pacemaker implantation were compared. Reported outcomes after transcatheter aortic valve implantation were compared with those of a subgroup including only degenerative valve disease and first redo. Results The incidence of permanent pacemaker implantation was 2.9%. Longer hospital stay ( p = 0.01), preexisting rhythm disorders ( p pacemaker implantation. Although prostheses were sutured with continuous monofilament in the majority of cases (86%), interrupted pledgetted sutures were used more often in the pacemaker group ( p = 0.002). In the subgroup analysis, the incidence of permanent pacemaker implantation was 2%; preexisting rhythm disorders and the suture technique were still major risk factors. Conclusion Permanent pacemaker implantation depends on etiology, preexisting rhythm disorders, and suture technique, and the 2% incidence compares favorably with the reported 5- to 10-fold higher incidence after transcatheter aortic valve implantation. Cost analysis should take this into account. Often dismissed as minor complication, permanent pacemaker implantation increases the risks of endocarditis, impaired myocardial recovery, and higher mortality if associated with prosthesis regurgitation.

Incidence and injury characteristics of traumatic brain injury: Comparison between children, adults and seniors in Israel.

Science.gov (United States)

Siman-Tov, Maya; Radomislensky, Irina; Knoller, Nachshon; Bahouth, Hany; Kessel, Boris; Klein, Yoram; Michaelson, Moshe; Avraham Rivkind, Bala Miklosh; Shaked, Gad; Simon, Daniel; Soffer, Dror; Stein, Michael; Jeroukhimov, Igor; Peleg, Kobi

2016-01-01

To assess the incidence and injury characteristics of hospitalized trauma patients diagnosed with TBI. A retrospective study of all injured hospitalized patients recorded in the National Trauma Registry at 19 trauma centres in Israel between 2002-2011. Incidence and injury characteristics were examined among children, adults and seniors. The annual incidence rate of hospitalized TBI for the Israeli population in 2011 was 31.8/100,000. Age-specific incidence was highest among seniors with a dramatic decrease in TBI-related mortality rate among them. Adults, in comparison to children and seniors, had higher rates of severe TBI, severe and critical injuries, more admission to the intensive care unit, underwent surgery, were hospitalization for more than 2 weeks and were discharged to rehabilitation. After adjusting for age, gender, ethnicity, mechanism of injury and injury severity score, TBI-related in-hospital mortality was higher among seniors and adults compared to children. Seniors are at high risk for TBI-related in-hospital mortality, although adults had more severe and critical injuries and utilized more hospital resources. However, seniors showed the most significant reduction in mortality rate during the study period. Appropriate intervention programmes should be designed and implemented, targeted to reduce TBI among high risk groups.

The effect of total knee arthroplasty on patients' balance and incidence of falls: a systematic review.

Science.gov (United States)

Moutzouri, M; Gleeson, N; Billis, E; Tsepis, E; Panoutsopoulou, I; Gliatis, J

2017-11-01

Despite the high incidence of falls in patients with OA, few studies have explored whether falls risk is affected after patients undergo total knee arthroplasty (TKA). Therefore, the aim of this systematic review was to identify the extent of the effects of TKA on balance and incidence of falls by critically reviewing the available literature. A systematic review of published literature sources was conducted up to March 2014. All studies assessing balance and incidence of falls after TKA (without physiotherapeutic intervention) were included. The methodological quality of each study was reviewed using the Critical Appraisal Skill Programme tool. Thirteen studies were included, comprising of ten cohort studies (Level II) and three studies with Level of evidence III. Findings provide evidence that TKA improves significantly single-limb standing balance (~60%) and dynamic balance up to 1-year following surgery (Level of evidence II). Moreover, TKA influences positively fear of falling and incidence of falls by switching 54.2 % of pre-operative fallers to post-operative non-fallers (Level of evidence II-III). It is highlighted that knee extension strength, proprioception and symmetrization of postural strategies have not fully recovered post-TKA and influence balance performance. Clinically, these persistent deficits need to be mitigated by physiotherapy even before TKA takes place.

Critical evaluation of incidence and prevalence of white spot lesions during fixed orthodontic appliance treatment: A meta-analysis.

Science.gov (United States)

Sundararaj, Dhinahar; Venkatachalapathy, Sudhakar; Tandon, Akshay; Pereira, Aaron

2015-01-01

Development of dental caries, specifically, white spot lesions (WSLs), continues to be a well-recognized and troubling side effect of orthodontic fixed appliance therapy, despite vast improvement in preventive dental techniques and procedures. The aim of this meta-analysis is to evaluate, determine, and summarize the incidence and prevalence rates of WSLs during orthodontic treatment that have been published in the literature. According to predetermined criteria, databases were searched for appropriate studies. References of the selected articles and relevant reviews were searched for any missed publications. In the 14 studies evaluated for WSLs, the incidence of new carious lesions formed during orthodontic treatment in patients was 45.8% and the prevalence of lesions in patients undergoing orthodontic treatment was 68.4%. The incidence and prevalence rates of WSLs in patients undergoing orthodontic treatment are quite high and significant. This widespread problem of WSL development is an alarming challenge and warrants significant attention from both patients and providers, which should result in greatly increased emphasis on effective caries prevention.

Criteria for classification and reporting of fire incidences in nuclear power plants of India

International Nuclear Information System (INIS)

Kapoor, R.K.

1998-01-01

Is is important that all fires in and around fire effective neighbourhood of Nuclear Power Plant (NPP) should be promptly reported (Reportable fires) and investigated. However, the depth of investigation and the range of authorities to whom the individual fire incidence need to be reported depends upon the severity of fire. In case of conventional non-chemical industries, the severity of fire depends mainly on the extent of loss caused by fire on property and the burn injury to persons. In case of NPP, two additional losses viz, release of radioactivity to working/public environment and the risk to safety related systems of NPP due to fire assume greater importance. This paper describes the criteria used in NPPs of India for classification of reportable fire incidences into four categories, viz. Insignificant, small, medium and large fires. It also gives the level of investigation depending upon the severity of fire. The fire classification scheme is explained in this paper with the help of worked out examples and two incidences of fire in Indian NPPs. (author)

Constipation in intensive care unit: incidence and risk factors.

Science.gov (United States)

Nassar, Antonio Paulo; da Silva, Fernanda Maria Queiroz; de Cleva, Roberto

2009-12-01

Although gastrointestinal motility disorders are common in critically ill patients, constipation and its implications have received very little attention. We aimed to determine the incidence of constipation to find risk factors and its implications in critically ill patients During a 6-month period, we enrolled all patients admitted to an intensive care unit from an universitary hospital who stayed 3 or more days. Patients submitted to bowel surgery were excluded. Constipation occurred in 69.9% of the patients. There was no difference between constipated and not constipated in terms of sex, age, Acute Physiology and Chronic Health Evaluation II, type of admission (surgical, clinical, or trauma), opiate use, antibiotic therapy, and mechanical ventilation. Early (constipation, a finding that persisted at multivariable analysis (P Constipation was not associated with greater intensive care unit or mortality, length of stay, or days free from mechanical ventilation. Constipation is very common among critically ill patients. Early enteral nutrition is associated with earlier return of bowel function.

Incidence of the acute renal failure in the intensive care unit at the General Hospital of Mexico: Risk factors and associated morbidity and mortality

OpenAIRE

Herrera-Méndez, J.; Sánchez-Velázquez, L.D.; González-Chávez, A.; Rodríguez-Terán, G.

2015-01-01

Background: The acute renal failure (ARF) contributes to a longer hospital stay, morbidity, mortality and use of resources in critical patients. The estimate of its incidence was difficult, mainly due to the lack of a generally accepted definition. Objective: To determine the incidence, risk factors and effects of the ARF in critical patients. Material and methods: Study of prospective cohort. Patients hospitalised in the Intensive Care Unit (ICU) were included. The population was di...

Acute myocardial infarctation in patients with critical ischemia underwent lower limb revascularization

Directory of Open Access Journals (Sweden)

Esdras Marques Lins

2013-12-01

Full Text Available BACKGROUND: Atherosclerosis is the main cause of peripheral artery occlusive disease (PAOD of the lower limbs. Patients with PAOD often also have obstructive atherosclerosis in other arterial sites, mainly the coronary arteries. This means that patients who undergo infrainguinal bypass to treat critical ischemia have a higher risk of AMI. There are, however, few reports in the literature that have assessed this risk properly. OBJECTIVE: The aim of this study was to determine the incidence of acute myocardial infarction in patients who underwent infrainguinal bypass to treat critical ischemia of the lower limbs caused by PAOD. MATERIAL AND METHODS: A total of 64 patients who underwent 82 infrainguinal bypass operations, from February 2011 to July 2012 were studied. All patients had electrocardiograms and troponin I blood assays during the postoperative period (within 72 hours. RESULTS: There were abnormal ECG findings and elevated blood troponin I levels suggestive of AMI in five (6% of the 82 operations performed. All five had conventional surgery. The incidence of AMI as a proportion of the 52 conventional surgery cases was 9.6%. Two patients died. CONCLUSION: There was a 6% AMI incidence among patients who underwent infrainguinal bypass due to PAOD. Considering only cases operated using conventional surgery, the incidence of AMI was 9.6%.

Gender differences in the relationship between gambling problems and the incidence of substance-use disorders in a nationally representative population sample.

Science.gov (United States)

Pilver, Corey E; Libby, Daniel J; Hoff, Rani A; Potenza, Marc N

2013-11-01

Cross-sectional studies have demonstrated gender-related differences in the associations between problem-gambling severity and substance-use disorders; however, these associations have not been examined longitudinally. We aimed to examine the prospective associations between problem-gambling severity and incident substance-use disorders in women versus men. Analyses were conducted using Wave-1 and Wave-2 NESARC data focusing on psychiatric diagnoses from 34,006 non-institutionalized US adults. Inclusionary criteria for pathological gambling were used to categorize Wave-1 participants as at-risk/problem gambling (ARPG) and non-ARPG (i.e. non-gambling/low-frequency gambling/low-risk gambling). Dependent variables included the three-year incidence of any substance-use disorder, alcohol-use disorders, nicotine dependence, drug-use disorders, prescription drug-use disorders, and illicit drug-use disorders. Significant gender-by-ARPG status interactions were observed with respect to the three-year incidence of nicotine dependence and prescription drug-use disorders, and approached significance with respect to incident alcohol-use disorders. ARPG (relative to non-ARPG) was positively associated with nicotine dependence among women (OR=2.00; 95% CI=1.24-3.00). ARPG was negatively associated with incident prescription drug-use disorders among men (OR=0.30; 95% CI=0.10-0.88)). Finally, ARPG was positively associated with incident alcohol-use disorders among men (OR=2.20; 95% CI=1.39-3.48). Gambling problems were associated with an increased 3-year incidence of nicotine dependence in women and alcohol dependence in men. These findings highlight the importance of considering gender in prevention and treatment initiatives for adults who are experiencing gambling problems. Moreover, the specific factors underlying the differential progressions of specific substance-use disorders in women and men with ARPG warrant identification. Copyright © 2013 Elsevier Ireland Ltd. All rights

Shift of the superconducting critical parameters due to correlated disorder

International Nuclear Information System (INIS)

Gitterman, M.; Shapiro, I.; Shapiro, B.Ya.

2012-01-01

Shift of the critical temperature and second critical magnetic field are calculated for a superconductor with Gaussian correlated disorder. All calculations have been performed in the framework of the stochastic Ginzburg-Landau equation. For uncorrelated disorder the macroscopic critical temperature is determined by the average of the local critical temperature across the sample, while for correlated disorder both the critical temperature and the upper critical magnetic field depend on disorder correlation length. In a nonuniform superconductor with randomly distributed local critical temperature both the macroscopic critical temperature and the upper critical magnetic field strongly depend on the characteristic correlation length ρ 0 of correlated disorder. The shift of the macroscopic critical parameters from those for non-correlated disorder, which does not exist for white noise, is obtained for small ρ 0 in the framework of the Ginzburg-Landau theory.

Critical feature analysis of a radiotherapy machine

International Nuclear Information System (INIS)

Rae, Andrew; Jackson, Daniel; Ramanan, Prasad; Flanz, Jay; Leyman, Didier

2005-01-01

The software implementation of the emergency shutdown feature in a major radiotherapy system was analyzed, using a directed form of code review based on module dependences. Dependences between modules are labelled by particular assumptions; this allows one to trace through the code, and identify those fragments responsible for critical features. An 'assumption tree' is constructed in parallel, showing the assumptions which each module makes about others. The root of the assumption tree is the critical feature of interest, and its leaves represent assumptions which, if not valid, might cause the critical feature to fail. The analysis revealed some unexpected assumptions that motivated improvements to the code

Incident solar radiation and coronary heart disease mortality rates in Europe

International Nuclear Information System (INIS)

Wong, Alfred

2008-01-01

The reported low mortality rate from coronary heart disease in Portugal, Spain, Italy, Greece, and France, to a lesser extent, has been attributed in numerous nutritional studies to the consumption of a Mediterranean-type diet. There are still many unresolved issues about the direct causal effect of the Mediterranean dietary regime on low incidence of coronary heart disease. An analysis of coronary heart disease mortality rates in Europe from a latitudinal gradient perspective has shown to have a close correlation to incident solar radiation. It is surmised that the resulting increased in situ biosynthesis of Vitamin D 3 could be the critical missing confounder in the analysis of the beneficial health outcome of the Mediterranean diet

Personality and language characteristics in parents from multiple-incidence autism families.

Science.gov (United States)

Piven, J; Palmer, P; Landa, R; Santangelo, S; Jacobi, D; Childress, D

1997-07-25

Several studies have suggested that the genetic liability for autism may be expressed in non-autistic relatives of autistic probands, in behavioral characteristics that are milder but qualitatively similar to the defining features of autism. We employ a variety of direct assessment approaches to examine both personality and language in parents ascertained through having two autistic children (multiple-incidence autism parents) and parents of Down syndrome probands. Multiple-incidence autism parents had higher rates of particular personality characteristics (rigidity, aloofness, hypersensitivity to criticism, and anxiousness), speech and pragmatic language deficits, and more limited friendships than parents in the comparison group. The implications of these findings for future genetic studies of autism are discussed.

Spatial analysis on human brucellosis incidence in mainland China: 2004–2010

Science.gov (United States)

Zhang, Junhui; Yin, Fei; Zhang, Tao; Yang, Chao; Zhang, Xingyu; Feng, Zijian; Li, Xiaosong

2014-01-01

Objectives China has experienced a sharply increasing rate of human brucellosis in recent years. Effective spatial monitoring of human brucellosis incidence is very important for successful implementation of control and prevention programmes. The purpose of this paper is to apply exploratory spatial data analysis (ESDA) methods and the empirical Bayes (EB) smoothing technique to monitor county-level incidence rates for human brucellosis in mainland China from 2004 to 2010 by examining spatial patterns. Methods ESDA methods were used to characterise spatial patterns of EB smoothed incidence rates for human brucellosis based on county-level data obtained from the China Information System for Disease Control and Prevention (CISDCP) in mainland China from 2004 to 2010. Results EB smoothed incidence rates for human brucellosis were spatially dependent during 2004–2010. The local Moran test identified significantly high-risk clusters of human brucellosis (all p values brucellosis incidence. PMID:24713215

Acute kidney injury in critically burned patients resuscitated with a protocol that includes low doses of Hydroxyethyl Starch

OpenAIRE

Sánchez-Sánchez, M.; Garcia-de-Lorenzo, A.; Cachafeiro, L.; Herrero, E.; Asensio, MJ.; Agrifoglio, A.; Flores, E.; Estebanez, B.; Extremera, P.; Iglesias, C.; Martinez, J.R..

2016-01-01

Acute kidney injury (AKI) is an important complication in burn patients. Recently, it has been recommended that hydroxyethyl starch (HES) be avoided in burn patients because it increases the incidence of AKI. Our purpose was to study incidence of AKI in critically ill burn patients resuscitated with Ringer’s solution and supplements of HES. We conducted an observational study of 165 patients admitted to the critical care burn unit (with 30 ± 15% TBSA burned). The main outcome measures were in...

Catastrophic Incident Recovery: Long-Term Recovery from an Anthrax Event Symposium

Energy Technology Data Exchange (ETDEWEB)

Lesperance, Ann M.

2008-06-30

On March 19, 2008, policy makers, emergency managers, and medical and Public Health officials convened in Seattle, Washington, for a workshop on Catastrophic Incident Recovery: Long-Term Recovery from an Anthrax Event. The day-long symposium was aimed at generating a dialogue about restoration and recovery through a discussion of the associated challenges that impact entire communities, including people, infrastructure, and critical systems.

Proper surface channelling of low energy argon ions incident on a nickel (110) crystal

International Nuclear Information System (INIS)

Evdokimov, I.N.; Berg, J.A. van den; Armour, D.G.

1979-01-01

The scattering behaviour of 6 keV argon ions from a nickel (110) surface has been investigated for specular reflection under grazing incidence conditions. The occurrence of an anomalously high energy loss has been confirmed and the transition from chain scattering at large scattering angles to a distinctly different type of scattering at small angles has been investigated. The characteristics of the low angle scattering phenomena, which dominate the observed spectra at scattering angles below about 18 0 , may be explained in terms of a surface hyperchannelling model in which the incident ions are confined to move within the shallow 'potential valleys' between two atomic rows in the surface. The critical angle for occurrence of this phenomena which is distinctly different from surface semichannelling has been evaluated with Lindhard's standard string potential. The experimentally measured critical angles are in good agreement with the calculated ones. (author)

How to maintain a business continuity despite cyber incidents?

OpenAIRE

Đekić Milica D.

2015-01-01

Modern IT systems can bring a lot of advantages in terms of electronic commerce and governance as well as an automatic process control within industry, traffic and the other ways of classical and critical infrastructure. However, beside many advantages regarding technological development, there are also some drawbacks in sense of cyber risks, threats and the real hacker's attacks. In this article, we plan to deal with all these cyber risks caused by IT incidents and emergency situations that ...

Toward Superconducting Critical Current by Design.

Science.gov (United States)

Sadovskyy, Ivan A; Jia, Ying; Leroux, Maxime; Kwon, Jihwan; Hu, Hefei; Fang, Lei; Chaparro, Carlos; Zhu, Shaofei; Welp, Ulrich; Zuo, Jian-Min; Zhang, Yifei; Nakasaki, Ryusuke; Selvamanickam, Venkat; Crabtree, George W; Koshelev, Alexei E; Glatz, Andreas; Kwok, Wai-Kwong

2016-06-01

A new critical-current-by-design paradigm is presented. It aims at predicting the optimal defect landscape in superconductors for targeted applications by elucidating the vortex dynamics responsible for the bulk critical current. To this end, critical current measurements on commercial high-temperature superconductors are combined with large-scale time-dependent Ginzburg-Landau simulations of vortex dynamics. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Critical Infrastructure Awareness Required by Civil Emergency Planning

NARCIS (Netherlands)

Luiijf, H.A.M.; Klaver, M.H.A.

2005-01-01

Modern societies are increasingly dependent on a set of critical products and services which comprise the Critical Infrastructure (CI). This makes Critical infrastructures increasingly important as a planning factor in case of emergencies. For that reason, we studied a number of emergencies and a

Critical role of SAP in progression and reactivation but not maintenance of T cell-dependent humoral immunity.

Science.gov (United States)

Zhong, Ming-Chao; Veillette, André

2013-03-01

Signaling lymphocytic activation molecule (SLAM)-associated protein (SAP) is a small adaptor molecule mutated in X-linked lymphoproliferative disease, a human immunodeficiency. SAP plays a critical role in the initiation of T cell-dependent B cell responses leading to germinal center reaction, the production of high-affinity antibodies, and B cell memory. However, whether SAP has a role in these responses beyond their initiation is not known. It is important to address this matter not only for mechanistic reasons but also because blockade of the SAP pathway is being contemplated as a means to treat autoimmune diseases in humans. Using an inducibly SAP deficient mouse, we found that SAP was required not only for the initiation but also for the progression of primary T cell-driven B cell responses to haptens. It was also necessary for the reactivation of T cell-dependent B cell immunity during secondary immune responses. These activities consistently correlated with the requirement of SAP for full expression of the lineage commitment factor Bcl-6 in follicular T helper (T(FH)) cells. However, once memory B cells and long-lived antibody-secreting cells were established, SAP became dispensable for maintaining T cell-dependent B cell responses. Thus, SAP is pivotal for nearly all phases, but not for maintenance, of T cell-driven B cell humoral immunity. These findings may have implications for the treatment of immune disorders by targeting the SAP pathway.

Frequency of Specific Categories of Aviation Accidents and Incidents During 2001-2010

Science.gov (United States)

Evans, Joni K.

2014-01-01

The purpose of this study was to determine the types of accidents or incidents that are most important to the aviation safety risk. All accidents and incidents from 2001-2010 were assigned occurrence categories based on the taxonomy developed by the Commercial Aviation Safety Team/International Civil Aviation Organization (CAST/ICAO) Common Taxonomy Team (CICTT). The most frequently recorded categories were selected within each of five metrics: total accidents, fatal accidents, total injuries, fatal injuries and total incidents. This analysis was done separately for events within Part 121, Scheduled Part 135, Non-Scheduled Part 135 and Part 91. Combining those five sets of categories resulted in groups of between seven and eleven occurrence categories, depending on the flight operation. These groups represent 65-85% of all accidents and 68-81% of incidents.

Critical shoulder angle in an East Asian population: correlation to the incidence of rotator cuff tear and glenohumeral osteoarthritis.

Science.gov (United States)

Shinagawa, Kiyotsugu; Hatta, Taku; Yamamoto, Nobuyuki; Kawakami, Jun; Shiota, Yuki; Mineta, Mitsuyoshi; Itoi, Eiji

2018-05-03

Focus has recently been on the critical shoulder angle (CSA) as a factor related to rotator cuff tear and osteoarthritis (OA) in the European population. However, whether this relationship is observed in the Asian population is unclear. The correlation between the CSAs measured on anteroposterior radiographs and the presence or absence of rotator cuff tears or OA changes was assessed in 295 patients. Rotator cuff tears were diagnosed with magnetic resonance imaging or ultrasonography. OA findings were classified using the Samilson-Prieto classification. The CSAs among the patients with rotator cuff tears, OA changes, and those without pathologies were compared. Multivariable analyses were used to clarify the potential risks for these pathologies. The mean CSA with rotator cuff tear (33.9° ± 4.1°) was significantly greater than that without a rotator cuff tear (32.3° ± 4.5°; P = .002). Multivariable analysis also showed that a greater CSA had a significantly increased risk of rotator cuff tears, with the odds ratio of 1.08 per degree. OA findings showed no significant correlation to the CSAs. Our study demonstrates that the CSA is greater in those with a rotator cuff tear than in those without a tear or OA changes, which may be an independent risk factor for the incidence of rotator cuff tears in the Japanese population. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Analysis of contributing factors associated to related patients safety incidents in Intensive Care Medicine.

Science.gov (United States)

Martín Delgado, M C; Merino de Cos, P; Sirgo Rodríguez, G; Álvarez Rodríguez, J; Gutiérrez Cía, I; Obón Azuara, B; Alonso Ovies, Á

2015-01-01

To explore contributing factors (CF) associated to related critical patients safety incidents. SYREC study pos hoc analysis. A total of 79 Intensive Care Departments were involved. The study sample consisted of 1.017 patients; 591 were affected by one or more incidents. The CF were categorized according to a proposed model by the National Patient Safety Agency from United Kingdom that was modified. Type, class and severity of the incidents was analyzed. A total 2,965 CF were reported (1,729 were associated to near miss and 1,236 to adverse events). The CF group more frequently reported were related patients factors. Individual factors were reported more frequently in near miss and task related CF in adverse events. CF were reported in all classes of incidents. The majority of CF were reported in the incidents classified such as less serious, even thought CF patients factors were associated to serious incidents. Individual factors were considered like avoidable and patients factors as unavoidable. The CF group more frequently reported were patient factors and was associated to more severe and unavoidable incidents. By contrast, individual factors were associated to less severe and avoidable incidents. In general, CF most frequently reported were associated to near miss. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Temperature dependence of critical current and transport current losses of 4 mm YBCO coated conductors manufactured using nonmagnetic substrate

Science.gov (United States)

Kvitkovic, J.; Hatwar, R.; Pamidi, S. V.; Fleshler, S.; Thieme, C.

2015-12-01

The temperature dependence of the critical current and AC losses were measured on American Superconductor Corporation's (AMSC) second generation high temperature superconducting (2G HTS) wire produced by Rolling Assisted Biaxially Textured Substrate (RABiTS) and Metal Organic Deposition (MOD) process. Wires manufactured with two types of substrates were characterized. The magnetic substrate with composition Ni5a%W exhibits a magnetic signature and has non-negligible AC losses in AC power applications. A new nonmagnetic substrate with an alloy composition Ni9a%W has been developed by AMSC to address the AC losses in 2G HTS. The data presented show that the performance of the new conductor is identical to the conductor with magnetic substrate in terms of critical current density. The data on AC losses demonstrate the absence of ferromagnetic loss component in the new conductor and significantly reduced AC losses at low to moderate values of I/Ic. The reduced losses will translate into reduced capital costs and lower operating costs of superconducting electrical devices for AC applications.

Measurement of the spatial resolution of wide-pitch silicon strip detectors with large incident angle

International Nuclear Information System (INIS)

Kawasaki, T.; Hazumi, M.; Nagashima, Y.

1996-01-01

As a part of R ampersand D for the BELLE experiment at KEK-B, we measured the spatial resolution of silicon strip detectors for particles with incident angles ranging from 0 degrees to 75 degrees. These detectors have strips with pitches of 50, 125 and 250 μm on the ohmic side. We have obtained the incident angle dependence which agreed well with a Monte Carlo simulation. The resolution was found to be 11 μm for normal incidence with a pitch of 50 μm, and 29 μm for incident angle of 75 degrees with a pitch of 250μm

Mass Casualty Chemical Incident Operational Framework, Assessment and Best Practices

Energy Technology Data Exchange (ETDEWEB)

Greenwalt, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hibbard, W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2016-08-09

Emergency response agencies in most US communities are organized, sized, and equipped to manage those emergencies normally expected. Hospitals in particular do not typically have significant excess capacity to handle massive numbers of casualties, as hospital space is an expensive luxury if not needed. Unfortunately this means that in the event of a mass casualty chemical incident the emergency response system will be overwhelmed. This document provides a self-assessment means for emergency managers to examine their response system and identify shortfalls. It also includes lessons from a detailed analysis of five communities: Baltimore, Boise, Houston, Nassau County, and New Orleans. These lessons provide a list of potential critical decisions to allow for pre-planning and a library of best practices that may be helpful in reducing casualties in the event of an incident.

Computer incident response and forensics team management conducting a successful incident response

CERN Document Server

Johnson, Leighton

2013-01-01

Computer Incident Response and Forensics Team Management provides security professionals with a complete handbook of computer incident response from the perspective of forensics team management. This unique approach teaches readers the concepts and principles they need to conduct a successful incident response investigation, ensuring that proven policies and procedures are established and followed by all team members. Leighton R. Johnson III describes the processes within an incident response event and shows the crucial importance of skillful forensics team management, including when and where the transition to forensics investigation should occur during an incident response event. The book also provides discussions of key incident response components. Provides readers with a complete handbook on computer incident response from the perspective of forensics team management Identify the key steps to completing a successful computer incident response investigation Defines the qualities necessary to become a succ...

BMI and obesity incidence in relation to food patterns of Polish older people

DEFF Research Database (Denmark)

Wadolowska, L.; Danowska-Oziewicz, M.; Niedzwiedzka, E.

2006-01-01

BMI differentiation and obesity incidence in relation to food patterns of Polish older people were analysed. The research included 422 people aged 65+ years. 21 food patterns were separated by the factor analysis. On the basis of the self-reported body mass and height, the BMI and percentages...... of overweight or obese people were calculated. The increase of the BMI and overweight and obesity incidence for both sexes was unequivocally connected with eating rye. The increase of the BMI and overweight and obesity incidence depended among women on consuming pork meat and alcoholic beverages. For men...

Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness

Science.gov (United States)

Plummer, Mark P.; Finnis, Mark E.; Phillips, Liza K.; Kar, Palash; Bihari, Shailesh; Biradar, Vishwanath; Moodie, Stewart; Horowitz, Michael; Shaw, Jonathan E.; Deane, Adam M.

2016-01-01

Objective Stress induced hyperglycemia occurs in critically ill patients who have normal glucose tolerance following resolution of their acute illness. The objective was to evaluate the association between stress induced hyperglycemia and incident diabetes in survivors of critical illness. Design Retrospective cohort study. Setting All adult patients surviving admission to a public hospital intensive care unit (ICU) in South Australia between 2004 and 2011. Patients Stress induced hyperglycemia was defined as a blood glucose ≥ 11.1 mmol/L (200 mg/dL) within 24 hours of ICU admission. Prevalent diabetes was identified through ICD-10 coding or prior registration with the Australian National Diabetes Service Scheme (NDSS). Incident diabetes was identified as NDSS registration beyond 30 days after hospital discharge until July 2015. The predicted risk of developing diabetes was described as sub-hazard ratios using competing risk regression. Survival was assessed using Cox proportional hazards regression. Main Results Stress induced hyperglycemia was identified in 2,883 (17%) of 17,074 patients without diabetes. The incidence of type 2 diabetes following critical illness was 4.8% (821 of 17,074). The risk of diabetes in patients with stress induced hyperglycemia was approximately double that of those without (HR 1.91 (95% CI 1.62, 2.26), phyperglycemia identifies patients at subsequent risk of incident diabetes. PMID:27824898

Hysteresis, critical fields and superferromagnetism of the film with perpendicular anisotropy

International Nuclear Information System (INIS)

Kalita, V.M.; Kulyk, M.M.; Ryabchenko, S.M.

2016-01-01

This paper is focused on the analysis of hysteresis and critical phenomena of magnetization reversal of superferromagnetic (SFM) state in nanogranular (NG) Co/Al 2 O 3 film with perpendicular anisotropy. It was demonstrated that the transition from the multidomain SFM state to the homogeneous SFM state, during the magnetization process, occurs critically. The value of the field of critical transition to the homogeneous state depends on the demagnetization field, granular anisotropy and interparticle exchange anisotropy. It turned out that the temperature dependence of the coercive force of the film, despite its SFM state, accords with the Neel–Brown formula for anisotropic single-domain ferromagnetic particles, but has an anomalous angular dependence. It was concluded that domain wall motion affects these features of the coercive field. The domain wall movement may occur due to the overturn of magnetic moments of particles in the boundaries between the superdomains. At the same time, the main factors influencing the coercivity are the anisotropy of the particles, which blocks their magnetic moment reorientation, and demagnetizing factor of the film. Together they lead to the anomalous angular dependence of the coercive field. - Highlights: • The transition from the multidomain SFM to homogeneous SFM state occurs critically. • The value of the critical field depends on the direction of the magnetizing field. • Critical transition field depends on the anisotropy of the interparticle exchange. • Dependence of H c (θ H ) differs from expected one for an ensemble of the particles. • Magnetization reversal occurs by turning the particle's moments in domain borders.

Oblique incidence of an electromagnetic wave in a cold inhomogeneous plasma. Introduction to a simplifying Lorentz transformation

International Nuclear Information System (INIS)

Bourdier, A.

1983-03-01

We present a method which simplifies the investigation of the form of an oblique incident wave on a plasma. The electric field vector of the wave is assumed to be in the plane of incidence. Our method consists in introducing a new frame in which the wave is normally incident. To do so, we use a LORENTZ transformation. This way, we reduce a two-dimensional problem to a one-dimensional one. In the new frame, relativistic terms due to the drift-velocity of the plasma are taken into consideration. The solution we obtain is complementary to GINSBURG's; it is accurate for small angles of incidences. We also describe another resonance taking place at four times the critical density (N 0 = 4 Nsub(c)) [fr

Precautions for preventing criticality at plutonium fuel treatment facilities

International Nuclear Information System (INIS)

Deworm, J.P.; Fieuw, G.; Cank, H. de

1976-01-01

Four criticality accidents took place between 1958 and 1964 at fuel processing plants using wet methods. So far accident of this type has taken place at production units where fissionable material is used. The prevention of criticality is one of the major concerns of the officials in charge of the plutonium fuel research laboratories operated at the Mol Nuclear Energy Study Centre by the SCK/CEN-Belgonucleaire Association. The means of preventing such an accident are of three types: introducing different types of treatment in well-defined work units; thorough analysis of planned experiments or fabrication programmes to determine the sub-criticality factors; application of technical and administrative procedures which ensure that the facilities are always sub-critical during the treatment and storage of fissionable materials. The installation includes a detection and warning system and provision is made for the immediate evacuation of staff should a crticality incident occur. The effects of a critical excursion on the building have been assessed. (author)

Field, temperature, and angle dependent critical current density Jc(H,T,θ) in coated conductors obtained via contact-free methods

International Nuclear Information System (INIS)

Thompson, J R; Christen, D K; Zhang Yifei; Zuev, Y L; Cantoni, C; Sinclair, J W; Chen Yimin; Selvamanickam, V

2010-01-01

Applications of coated conductors based on high- T c superconductors often require detailed knowledge of their critical current density J c as a function of magnetic field orientation as well as field strength and temperature. This work demonstrates experimental methods for obtaining the angularly dependent J c using contact-free magnetic measurements, and qualifies those methods using several well defined conditions. The studies complement traditional transport techniques and are readily extended to conditions of field and temperature where the current density is very large and transport methods become difficult. Results on representative materials are presented.

The Citadel, Trying Hard to Shed Old-South Image, Set Back by 'the Incident.'

Science.gov (United States)

Hirschorn, Michael W.

1987-01-01

The Citadel, a state institution, has attempted to push for a broad-based education in languages, history, and literature while maintaining its 145-year-old tradition of military discipline and training. An incident with a black cadet has brought on a barrage of public criticism. (MLW)

Orientation-dependent ion beam sputtering at normal incidence conditions in FeSiAl alloy

International Nuclear Information System (INIS)

Batic, Barbara Setina; Jenko, Monika

2010-01-01

The authors have performed Ar+ broad ion beam sputtering of a polycrystalline Fe-Si-Al alloy at normal incidence at energies varying from 6 to 10 keV. Sputtering results in the formation of etch pits, which can be classified in three shapes: triangular, rectangular, and square. As each grain of individual orientation exhibits a certain type of pattern, the etch pits were correlated with the crystal orientations by electron backscattered diffraction technique.